Organization
LUTHERAN CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EMILY J. MILLER (ADMINISTRATOR)
(618) 483-6136
Entity
Organization
Contact information
Practice address
702 W CUMBERLAND RD, ALTAMONT, IL 62411-1053
(618) 483-6136
(618) 483-5607
Mailing address
702 W CUMBERLAND RD, ALTAMONT, IL 62411-1053
(618) 483-6136
(618) 483-5607
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
—
IL
314000000X
Skilled Nursing Facility
Primary
0025023
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0025023
LONG TERM CARE LICENSE
IL
05
—
IL6005599
—
IL
Enumeration date
11/09/2005
Last updated
02/22/2023
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