Provider Demographics
NPI:1245408053
Name:THE MANOR AT SALEM WOODS, L.P.
Entity Type:Organization
Organization Name:THE MANOR AT SALEM WOODS, L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-594-8581
Mailing Address - Street 1:441 S. HOTZE RD.
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:IL
Mailing Address - Zip Code:62881
Mailing Address - Country:US
Mailing Address - Phone:618-548-8910
Mailing Address - Fax:618-548-8939
Practice Address - Street 1:441 S. HOTZE RD.
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:IL
Practice Address - Zip Code:62881
Practice Address - Country:US
Practice Address - Phone:618-548-8910
Practice Address - Fax:618-548-8939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility