Mcleansboro Hco, LLC
NPI #1528691797 in Mc Leansboro, Illinois
Provider Information
- NPI Number
- 1528691797
- Entity Type
- Organization
- Organization Name
- Mcleansboro Hco, LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Feb 17, 2020
- Last Updated
- Feb 17, 2020
Practice Location
- Address
- 405 W CARPENTER ST
- City
- Mc Leansboro
- State
- Illinois
- ZIP Code
- 62859-1012
- Phone
- (618) 643-3728
Authorized Official
- Name
- MARK B. PETERSEN
- Title
- MANAGER
- Phone
- (309) 691-8113
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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