Organization
MENARD CONVALESCENT CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY W JENNINGS (CONTROLLER)
(217) 787-8530
Entity
Organization
Contact information
Practice address
120 W ANTLE ST, PETERSBURG, IL 62675-1035
(217) 632-2249
(217) 632-7810
Mailing address
2653 W LAWRENCE AVE STE B, SPRINGFIELD, IL 62704-1115
(217) 787-8530
(217) 785-9840
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0003020
IL
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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