New Athens Home for the Aged Inc
Organization Active NPI Nursing Facility/Intermediate Care Facility · New Athens, IL
NPI 1013986439 · NPPES record last updated Aug 6, 2013
Key facts
- NPI
- 1013986439
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nursing Facility/Intermediate Care Facility 313M00000X
- License
- 0033043 (IL)
- Legal business name
- NEW ATHENS HOME FOR THE AGED INC
- Practice address
- 203 S Johnson St
New Athens, IL 62264-1319 - Phone
- (618) 475-2550
- Fax
- (618) 475-2567
- NPI assigned
- Mar 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Gary Wynn Holtgrewe
- Title
- Administrator
- Phone
- (618) 475-2550
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 0033043 | IL | Yes |
Addresses
Primary practice location
203 S Johnson St
New Athens, IL 62264-1319
Mailing address
203 S Johnson St
New Athens, IL 62264-1319
Phone (618) 475-2550
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14E299 | Other | IL | PUBLIC HEALTH ID # |
| 14-0061 | Medicaid | IL |
Other providers in New Athens, IL
- Joseph J Harper
- Lindsey Lehr
- Lynn Eichelberger Fiedler
- Kent D. McConnell
- New Athens Cu School Dist 60
- Steven Mark Newbold
- Derek A Niehaus
- PC Associates, LLC
- David P. Schwartz
- Megan Lynn Seemann
All providers in New Athens, IL · Nursing Facility/Intermediate Care Facility in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.