Organization
COUNTY OF WINNEBAGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA PLYMALE LNHA (ASSISTANT ADMINISTRATOR)
(815) 921-9200
Entity
Organization
Contact information
Practice address
404 ELM ST, ROCKFORD, IL 61101-1239
(815) 921-9200
(815) 877-8304
Mailing address
4401 N MAIN ST, ROCKFORD, IL 61103-1277
(815) 921-9200
(815) 877-8304
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5611
IL
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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