Organization · Type 2 NPI

Henry & Jane Vonderlieth Living Center Inc

Skilled Nursing Facility · Mount Pulaski, IL

NPI number 1376538157 Active

Practice location

1120 N Topper Dr
Mount Pulaski, IL 62548-1401

Call (217) 792-3218 Map

Fax (217) 792-3210

Mailing address

115 W Jefferson St, Ste 401
Bloomington, IL 61701-3967

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	19976 (IL)

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

5 other providers at this address

NPI record

NPI: 1376538157
Entity type: Organization (Type 2)
Issued: Sep 16, 2005
Last updated: May 30, 2017
Status: Active

Other names

<unavail>
The H & J Vonderlieth LVG CTR · doing business as
The Henry & Jane Vonderlieth Living Center · doing business as

Authorized official

Mr. David M Underwood
Sr. VP & CFO
(309) 823-7135

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1376538157

Henry & Jane Vonderlieth Living Center Inc's National Provider Identifier is 1376538157, issued on Sep 16, 2005. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Mount Pulaski, IL. The record was last updated on May 30, 2017.