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Organization
DEVELOPMENTAL PLANNING & SERVICES INC
Active
Organization
DEVELOPMENTAL PLANNING & SERVICES INC
Active
Other names
RESERVOIR MANOR
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS K HEADLEE (PRESIDENT)
(618) 244-7701
Entity
Organization
Contact information
Practice address
419 E. MAIN STREET, SHELBYVILLE, IL 62565-1600
(217) 774-9544
(217) 774-9545
Mailing address
PO BOX 2369, MOUNT VERNON, IL 62864-0046
(618) 244-7701
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0051060
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0051060
DEPARTMENT OF PUBLIC HEALTH
IL
01
—
14G082
PROVIDER IDENTIFICATION NUMBER
IL
01
—
6007835
FACILITY ID
—
Enumeration date
07/23/2010
Last updated
08/17/2018
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