Organization
COUNTY OF FULTON
Active
Other names
The Clayberg Fulton County Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARTHA J DANIELSON LNHA (ADMINISTRATOR)
(309) 785-5012
Entity
Organization
Contact information
Practice address
625 EAST MONROE STREET, CUBA, IL 61427-0200
(309) 785-5012
(309) 785-5376
Mailing address
PO BOX 200, 625 EAST MONROE STREET, CUBA, IL 61427-0200
(309) 785-5012
(309) 785-5376
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
0014290
IL
314000000X
Skilled Nursing Facility
0014290
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370914241001
—
IL
Enumeration date
03/14/2007
Last updated
11/02/2012
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