Organization Name: | HEARTLAND OF PAXTON IL LLC |
NPI Number: | 1366489601 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BARRY A LAZARUS (VICE PRESIDENT - REIMBURSEMENTS) |
Mailing Address: | 1001 E Pells St Paxton |
State: | IL US |
Postal Code: | 609571300 |
Phone Number: | 2173794361 |
Fax Number: | 2173793325 |
NPI Enumeration Date: | 06/02/2006 |
NPI Last Update Date: | 04/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |