Organization
CHARLESTON HCO LLC
Active
Other names
Charleston Rehab & Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE REDBURN (REVENUE CYCLE COMPLIANCE AUDITOR)
(816) 444-0900
Entity
Organization
Contact information
Practice address
716 18TH ST, CHARLESTON, IL 61920-2382
(217) 345-7054
(217) 348-1264
Mailing address
716 18TH ST, CHARLESTON, IL 61920-2382
(217) 345-7054
(816) 276-0150
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0040311
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270376016009
—
IL
Enumeration date
10/13/2006
Last updated
10/16/2024
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