Elmwood Nursing & Rehabilitation Center, L.L.C.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0041210 Issued in IL

Legal business name

ELMWOOD NURSING & REHABILITATION CENTER, L.L.C.

Practice address

152 Wilma Dr
Maryville, IL 62062-5435

Phone

(618) 344-7750

Fax

(618) 344-3520

NPI assigned

Jun 5, 2006

Last updated

Jun 2, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Makhlouf Suissa

Title

Member

Phone

(618) 344-7750

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1831138890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 WILMA DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625435",
            "telephone_number": "618-344-7750",
            "fax_number": "618-344-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 WILMA DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625435",
            "telephone_number": "618-344-7750",
            "fax_number": "618-344-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMWOOD NURSING & REHABILITATION CENTER, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "SUISSA",
        "authorized_official_first_name": "MAKHLOUF",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "618-344-7750",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0041210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.