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DECATUR MANOR HEALTHCARE, LLC

Intermediate Care Facility, Mental Illness

Decatur, Illinois

Provider NPI: 1134126063

Organization Information:
Organization Name:  DECATUR MANOR HEALTHCARE, LLC


Practice Location:
1016 W PERSHING RD  DECATUR, IL 62526 US
Tel: 217-875-0833  Fax: --

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


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N310500000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mental Illness
Y310500000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mental Illness
IL0049262

Other Provider Identifiers:

IssuerNumberStateType
612731133IL05
31CX5IL05
370969602IL05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




INTERMEDIATE CARE JOBS IL - Page 1



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