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Hickory Estates
Intellectual Disabilities Intermediate Care Facility in Sumner, Illinois
NPI 1013182807

Hickory Estates is a Intellectual Disabilities Intermediate Care Facility based in Sumner, IL. Hickory Estates practices in Sumner, IL. The NPI Number for Hickory Estates is 1013182807 and holds a License No. 0030510 (Illinois).

The current practice location address for Hickory Estates is 310 Otha Street, Sumner, IL and can be reached out via phone at 618-936-2004 and via fax at 618-936-2556.

Location: 310 Otha Street, Sumner, IL, 62466
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1013182807
Provider Name
Hickory Estates
Credential
Provider Entity Type
Organization
Address
310 Otha Street, Sumner, IL, 62466
Phone Number
618-936-2004
Fax Number
618-936-2556
Provider Enumeration Date
04/23/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
14G105 05 IL
institution
Provider Business Practice Location Address Details
Address
310 Otha Street
City
Sumner
State
Illinois
Zip
62466-0164
Phone Number
618-936-2004
Fax Number
618-936-2556
person
Provider Business Mailing Address Details
Address
310 Otha Street
City
Sumner
State
Illinois
Zip
62466-0164
Phone Number
618-936-2004
Fax Number
618-936-2556
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
0030510 (Illinois)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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