Organization
CRG EM OPERATOR, LLC
Active
Other names
East Moline Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY KAGAN (MANAGER)
(410) 877-6630
Entity
Organization
Contact information
Practice address
430 30TH AVE, EAST MOLINE, IL 61244-3152
(309) 755-3466
Mailing address
10 SUDBROOK LN STE 102, BALTIMORE, MD 21208-4147
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14-6041
MEDICARE CERTIFICATION NUMBER
—
Enumeration date
09/27/2010
Last updated
02/11/2011
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