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LIVING IN A FAMILY ENVIRONMENT MANAGEMENT CORPORATION

Intermediate Care Facility, Mentally Retarded

Makanda, Illinois

Provider NPI: 1063503647

Organization Information:
Organization Name:  LIVING IN A FAMILY ENVIRONMENT MANAGEMENT CORPORATION


Practice Location:
3136 MYERS LN  MAKANDA, IL 62958 US
Tel: 618-967-7106  Fax: --

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


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y320900000XResidential Treatment Facilities
Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities
IL201300019S

Other Provider Identifiers:

IssuerNumberStateType
201300019SIL05
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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