Organization
WATERS OF LEBANON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOISHE GUBIN (OWNER)
(708) 449-1900
Entity
Organization
Contact information
Practice address
1585 PERRY WORTH RD, LEBANON, IN 46052-9635
(765) 482-6391
Mailing address
240 FENCL LN, HILLSIDE, IL 60162-2067
(708) 449-1900
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/13/2017
Last updated
07/13/2017
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