Organization
ELDERCARE INC
Active
Other names
Calvin Johnson Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN C WOLF (PRESIDENT)
(618) 234-2273
Entity
Organization
Contact information
Practice address
727 N 17TH ST, BELLEVILLE, IL 62226-6552
(618) 234-3323
(618) 234-9477
Mailing address
2810 FRANK SCOTT PKWY W, SUITE 820, BELLEVILLE, IL 62223-5007
(618) 234-2273
(618) 234-7777
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
IL
314000000X
Skilled Nursing Facility
Primary
0023309
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V255P6570911
VA VETERANS ADMIN
—
Enumeration date
11/15/2005
Last updated
04/20/2008
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