Basic Information
| Provider Information | |||||||||
| NPI: | 1851389290 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SANDWICH REHABILITATION & HEALTH CARE CENTER | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 902 E ARNOLD ST | ||||||||
| Address2: | |||||||||
| City: | SANDWICH | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605481119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157868409 | ||||||||
| FaxNumber: | 8157863830 | ||||||||
| Practice Location | |||||||||
| Address1: | 902 E ARNOLD ST | ||||||||
| Address2: | |||||||||
| City: | SANDWICH | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605481119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157868409 | ||||||||
| FaxNumber: | 8157863830 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | THOMAS | ||||||||
| AuthorizedOfficialFirstName: | LEANN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8157868409 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 313M00000X | 1652783 | IL | Y | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility |
No ID Information.