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Lebanon Terrace
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Lebanon, Illinois
NPI 1104945716

Lebanon Terrace is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Lebanon, IL. Lebanon Terrace practices in Lebanon, IL. The NPI Number for Lebanon Terrace is 1104945716 and holds a License No. 0038430 (Illinois).

The current practice location address for Lebanon Terrace is 221 E 3Rd St, Lebanon, IL and can be reached out via phone at 618-537-4133 and via fax at 618-537-4156.

Location: 221 E 3Rd St, Lebanon, IL, 62254-1668
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104945716
Provider Name
Lebanon Terrace
Credential
Provider Entity Type
Organization
Address
221 E 3Rd St, Lebanon, IL, 62254-1668
Phone Number
618-537-4133
Fax Number
618-537-4156
Provider Enumeration Date
03/28/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
221 E 3Rd St
City
Lebanon
State
Illinois
Zip
62254-1668
Phone Number
618-537-4133
Fax Number
618-537-4156
person
Provider Business Mailing Address Details
Address
221 E 3Rd St
City
Lebanon
State
Illinois
Zip
62254-1668
Phone Number
618-537-4133
Fax Number
618-537-4156
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
0038430 (Illinois)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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