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Independence Place, Inc.
Nursing Facility/Intermediate Care Facility in Herrin, Illinois
NPI 1871717678

Independence Place, Inc. is a Nursing Facility/Intermediate Care Facility based in Nashville, IL. Independence Place, Inc. practices in Herrin, IL. The NPI Number for Independence Place, Inc. is 1871717678 and holds a License No. 0037994 (Illinois).

The current practice location address for Independence Place, Inc. is 1705 S Park Ave, Herrin, IL and can be reached out via phone at 618-942-7964 and via fax at 618-942-6191.

Location: 1705 S Park Ave, Herrin, IL, 62263-4815
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1871717678
Provider Name
Independence Place, Inc.
Credential
Provider Entity Type
Organization
Address
1705 S Park Ave, Herrin, IL, 62263-4815
Phone Number
618-942-7964
Fax Number
618-942-6191
Provider Enumeration Date
04/12/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1705 S Park Ave
City
Herrin
State
Illinois
Zip
62948-4166
Phone Number
618-942-7964
Fax Number
618-942-6191
person
Provider Business Mailing Address Details
Address
1705 S Park Ave
City
Herrin
State
Illinois
Zip
62948-4166
Phone Number
618-942-7964
Fax Number
618-942-6191
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Nursing Facility/Intermediate Care Facility
Speciality
-
Taxonomy
313M00000X
License No.
0037994 (Illinois)
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
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