ST. MARYS HEALTH CARE CENTER INVESTORS LLC
Custodial Care Facility
Edwardsville, Illinois
Provider NPI: 1558343301
Organization Information:Organization Name: ST. MARYS HEALTH CARE CENTER INVESTORS LLC
Practice Location:
401 SAINT MARYS DR EDWARDSVILLE, IL 62025 US
Tel: 618-692-1330 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
401 SAINT MARYS DR EDWARDSVILLE, IL 62025 US
Tel: 618-692-1330 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 311Z00000X | Nursing & Custodial Care Facilities Custodial Care Facility | ||
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
NPI | 1558343301 | IL | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin