JACK MABLEY DEVELOPMENTAL CENTER
NPI 1376525204
Intermediate Care Facility, Intellectual Disabilities in Dixon, IL
- Organization
- Intermediate Care Facility, Intellectual...
About JACK MABLEY DEVELOPMENTAL CENTER
This page provides the complete NPI Profile along with additional information for Jack Mabley Developmental Center, a provider established in Dixon, Illinois operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1376525204 assigned on November 2005. The practitioner's primary taxonomy code is 315P00000X with license number 830600 (IL). The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's other name is Jack Mabley Developmental Center. The authorized official of this NPI record is Debra Muhlstadt (Fiscal Administrator, Sodc Operatio)
- NPI
- 1376525204 Verify this NPI
- Provider Legal Name
- ILLINOIS DEPARTMENT OF HUMAN SERVICES
- Other Organization Name
- JACK MABLEY DEVELOPMENTAL CENTER
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 1120 WASHINGTON AVE DIXON, IL 61021
- Location Phone
- (815) 288-8301
- Location Fax
- (815) 288-8398
- Mailing Address
- 1120 WASHINGTON AVE DIXON, IL 61021
- Mailing Phone
- (815) 288-8301
- Mailing Fax
- (815) 288-8398
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-16-2005
- Last Update Date
- 12-22-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Intermediate Care Facility, Intellectual Disabilities
- Taxonomy Code
- 315P00000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 830600
- License State
- IL
- Taxonomy Description
- An intermediate care facility providing services for individuals with intellectual disabilities.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| E63807 | MEDICARE UPIN (02) | IL | |
| 830600 | MEDICARE UPIN (02) | IL | |
| T38623 | MEDICARE UPIN (02) | IL | |
| C43534 | MEDICARE UPIN (02) | IL |
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Other Providers at the Same Location
The following 7 providers are registered at the same or a nearby location.
DIXON, IL 61021
DIXON, IL 61021
DIXON, IL 61021
DIXON, IL 61021
DIXON, IL 61021
DIXON, IL 61021
DIXON, IL 61021
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376525204, enumerated as an "organization" on November 16, 2005.
The provider is located at 1120 WASHINGTON AVE DIXON, IL 61021 and the phone number is (815) 288-8301.
Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
