Organization
IMBODEN CREEK SENIOR LIVING & REHABILITATION LLC
Active
Other names
Imboden Creek Senior Living & Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT E STOUT LNHA (OWNER)
(618) 294-8696
Entity
Organization
Contact information
Practice address
180 W IMBODEN DR, DECATUR, IL 62521-5238
(217) 422-6464
Mailing address
215 E LOCUST ST, HARRISBURG, IL 62946-1504
(618) 294-8696
(618) 294-8699
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
01/05/2022
Last updated
04/25/2022
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