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Organization

LEWIS MEMORIAL CHRISTIAN VILLAGE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELLEY HENRY (SLP)
(217) 787-9600
Entity
Organization

Contact information

Practice address
3400 W WASHINGTON ST, SPRINGFIELD, IL 62711-7917
(217) 787-9600
Mailing address
3400 W WASHINGTON ST, SPRINGFIELD, IL 62711-7917
(217) 787-9600

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
146008433
IL

Other

Enumeration date
09/14/2010
Last updated
09/14/2010
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