Bushnell Dix Hill Jones 694110
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Jacksonville, IL. Organization (NPI-2).
NPI number1154465243
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1154465243
- Entity type
- Organization (NPI-2)
- Legal business name
- Bushnell Dix Hill Jones 694110
- Organization subpart
- No
- Enumeration date
- Feb 20, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
Other names
- Jacksonville Developmental Center (Doing Business As)
Practice location
1201 S Main StJacksonville, IL 62650-3339
Phone 217-479-2120 · Fax 217-243-8920
Mailing address
1201 S Main StJacksonville, IL 62650-3339
Phone 217-479-2120 · Fax 217-243-8920
Authorized official
Susie Pennell
Administrative Asst
2174792120
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