Provider Demographics
NPI:1902971021
Name:SPRING VALLEY NURSING CENTER
Entity Type:Organization
Organization Name:SPRING VALLEY NURSING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-664-4708
Mailing Address - Street 1:1300 NORTH GREENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:IL
Mailing Address - Zip Code:61362-1576
Mailing Address - Country:US
Mailing Address - Phone:815-664-4708
Mailing Address - Fax:815-663-2527
Practice Address - Street 1:1300 NORTH GREENWOOD ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:IL
Practice Address - Zip Code:61362-1576
Practice Address - Country:US
Practice Address - Phone:815-664-4708
Practice Address - Fax:815-663-2527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0025270Medicaid
IL145486Medicare Oscar/Certification