Galesburg Terrace Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0042317 Issued in IL

Legal business name

GALESBURG TERRACE INC.

Practice address

1145 Frank St
Galesburg, IL 61401-2421

Phone

(309) 342-2103

Fax

(309) 342-1819

NPI assigned

Jan 25, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Ethel Z Logue

Title

Administrator

Phone

(309) 342-2103

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234137600000",
    "number": "1487624946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 FRANK ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012421",
            "telephone_number": "309-342-2103",
            "fax_number": "309-342-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 FRANK ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012421",
            "telephone_number": "309-342-2103",
            "fax_number": "309-342-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALESBURG TERRACE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2009-02-09",
        "status": "A",
        "authorized_official_last_name": "LOGUE",
        "authorized_official_first_name": "ETHEL",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "309-342-2103",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0042317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Galesburg, IL
• Providers in Galesburg, 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 Feb 9, 2009; 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.