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Gillespie 694140
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Jacksonville, Illinois
NPI 1881738979

Gillespie 694140 is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Jacksonville, IL. Gillespie 694140 practices in Jacksonville, IL. The NPI Number for Gillespie 694140 is 1881738979 and holds a License No. (Illinois).

The current practice location address for Gillespie 694140 is 1201 S Main St, Jacksonville, IL and can be reached out via phone at 217-479-2120 and via fax at 217-243-8920.

Location: 1201 S Main St, Jacksonville, IL, 62650-3339
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1881738979
Provider Name
Gillespie 694140
Credential
Provider Entity Type
Organization
Address
1201 S Main St, Jacksonville, IL, 62650-3339
Phone Number
217-479-2120
Fax Number
217-243-8920
Provider Enumeration Date
02/20/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
694140 05 IL
institution
Provider Business Practice Location Address Details
Address
1201 S Main St
City
Jacksonville
State
Illinois
Zip
62650-3339
Phone Number
217-479-2120
Fax Number
217-243-8920
person
Provider Business Mailing Address Details
Address
1201 S Main St
City
Jacksonville
State
Illinois
Zip
62650-3339
Phone Number
217-479-2120
Fax Number
217-243-8920
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
()
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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Intellectual and/or Developmental Disabilities Residential Treatment Facility
1201 S Main St,
JACKSONVILLE, IL
62650-3339
217-479-2120
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