Lebanon Hco, LLC

NPI #1346873510 in Lebanon, Illinois

Provider Information

NPI Number
1346873510
Entity Type
Organization
Organization Name
Lebanon Hco, LLC
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Feb 17, 2020
Last Updated
Feb 17, 2020

Practice Location

Address
1201 N ALTON ST
ZIP Code
62254-1103
Phone
(618) 537-4401

Authorized Official

Name
MARK B. PETERSEN
Title
MANAGER
Phone
(309) 691-8113

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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