Organization
WOODRIDGE OF GALESBURG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHALL A MIAER (MANAGER)
(847) 679-8219
Entity
Organization
Contact information
Practice address
261 N LINWOOD RD, GALESBURG, IL 61401-3279
(309) 344-4100
(309) 344-4101
Mailing address
261 N LINWOOD RD, GALESBURG, IL 61401-3279
(309) 344-4100
(309) 344-4101
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2634122952
—
IL
Enumeration date
12/15/2008
Last updated
12/15/2008
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