Organization
PLYMOUTH PLACE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE LILBURN (C.E.O.)
(708) 482-6668
Entity
Organization
Contact information
Practice address
315 N LA GRANGE RD, LA GRANGE PARK, IL 60526-1903
(708) 482-6668
Mailing address
315 N. LA GRANGE ROAD, LA GRANGE PARK, IL 60526-5695
(708) 482-6668
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0012898
IL
Other
Enumeration date
03/05/2007
Last updated
07/29/2013
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