Edwardsville Nh LLC
NPI #1730622457 in Edwardsville, Illinois
Provider Information
- NPI Number
- 1730622457
- Entity Type
- Organization
- Organization Name
- Edwardsville Nh LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Nov 29, 2016
- Last Updated
- Jun 25, 2021
Practice Location
- Address
- 6277 CENTER GROVE RD
- City
- Edwardsville
- State
- Illinois
- ZIP Code
- 62025-3309
- Phone
- (618) 659-0605
Authorized Official
- Name
- JAMES MASON
- Title
- PRESIDENT
- Phone
- (813) 347-7425
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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