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JJR ENTERPRISES INC

Adult Care Home

Mount Vernon, Illinois

Provider NPI: 1326110594

Organization Information:
Organization Name:  JJR ENTERPRISES INC


Practice Location:
2025 BROADWAY ST STE B  MOUNT VERNON, IL 62864 US
Tel: 618-244-7701  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility
Adult Care Home
IL96S007

Other Provider Identifiers:

IssuerNumberStateType
CILA LICENSE96S007IL01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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