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Good Shepherd Manor Inc
Intellectual Disabilities Intermediate Care Facility in Momence, Illinois
NPI 1750659199

Good Shepherd Manor Inc is a Intellectual Disabilities Intermediate Care Facility based in Momence, IL. Good Shepherd Manor Inc practices in Momence, IL. The NPI Number for Good Shepherd Manor Inc is 1750659199 and holds a License No. 0051466 (Illinois).

The current practice location address for Good Shepherd Manor Inc is 4003 N. Routes 1 & 17, Momence, IL and can be reached out via phone at 815-472-3700 and via fax at 815-472-6086. You can also correspond with Good Shepherd Manor Inc through the mailing address at PO BOX 260, MOMENCE, IL - 60954-0260 (mailing address contact number: 815-472-3700).

Location: 4003 N. Routes 1 & 17, Momence, IL, 60954-0260
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1750659199
Provider Name
Good Shepherd Manor Inc
Credential
Provider Entity Type
Organization
Address
4003 N. Routes 1 & 17, Momence, IL, 60954-0260
Phone Number
815-472-3700
Fax Number
815-472-6086
Provider Enumeration Date
12/13/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4003 N. Routes 1 & 17
City
Momence
State
Illinois
Zip
60954-0260
Phone Number
815-472-3700
Fax Number
815-472-6086
person
Provider Business Mailing Address Details
Address
Po Box 260
City
Momence
State
Illinois
Zip
60954-0260
Phone Number
815-472-3700
Fax Number
815-472-6086
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
0051466 (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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