Grange Nursing Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0014399 Issued in IL

Legal business name

GRANGE NURSING HOME

Practice address

901 N 10TH St
Mascoutah, IL 62258-1017

Phone

(618) 566-2183

Fax

(618) 566-4462

NPI assigned

Oct 20, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Sheila Renee Storey, LNHA

Title

Administrator

Phone

(618) 566-2183

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366431447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N 10TH ST",
            "city": "MASCOUTAH",
            "state": "IL",
            "postal_code": "622581017",
            "telephone_number": "618-566-2183",
            "fax_number": "618-566-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N 10TH ST",
            "city": "MASCOUTAH",
            "state": "IL",
            "postal_code": "622581017",
            "telephone_number": "618-566-2183",
            "fax_number": "618-566-4462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANGE NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STOREY",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-566-2183",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0014399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Mascoutah, IL
• Providers in Mascoutah, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.