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JJR ENTERPRISES INC

Intermediate Care Facility, Mentally Retarded

Mount Vernon, Illinois

Provider NPI: 1962576769

Organization Information:
Organization Name:  JJR ENTERPRISES INC


Practice Location:
4241 LINCOLNSHIRE DR  MOUNT VERNON, IL 62864 US
Tel: 618-242-0132  Fax: --

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


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
IL0043810

Other Provider Identifiers:

IssuerNumberStateType
PROVIDER IDENTIFICATION #14G198IL01
LG TERM CARE ICF DD 160043810IL01
FACILITY ID6011860IL01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS IL - Page 1



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