Organization
BRETHREN HOME
Active
Other names
PINECREST MANOR
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL A DAVIS MBA NHA (CEO/ADMINISTRATOR)
(815) 734-4103
Entity
Organization
Contact information
Practice address
414 S WESLEY AVE, MOUNT MORRIS, IL 61054-1428
(815) 734-4103
(815) 734-7318
Mailing address
414 S WESLEY AVE, MOUNT MORRIS, IL 61054-1428
(815) 734-4103
(815) 734-7318
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
10/16/2008
Last updated
01/20/2009
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