Organization
EDWARDSVILLE CARE CENTER, LLC
Active
Other names
Edwardsville Nursing & Rehabiliation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAKHLOUF SUISSA (MANAGER/MEMBER OF LLC)
(917) 744-8688
Entity
Organization
Contact information
Practice address
401 SAINT MARYS DR, EDWARDSVILLE, IL 62025-4276
(618) 692-1330
Mailing address
1401 S BRENTWOOD BLVD STE 475, BRENTWOOD, MO 63144-1437
(314) 963-7570
(314) 963-9030
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
01/12/2018
Last updated
01/12/2018
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