Organization
CARAVILLA RESIDENTIAL CENTERS, INC
Active
Other names
MT VERNON CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL F FLANAGAN (CORPORATE ATTORNEY)
(816) 444-0900
Entity
Organization
Contact information
Practice address
1717 JEFFERSON AVE, MOUNT VERNON, IL 62864-4330
(618) 244-2861
(618) 244-2393
Mailing address
1717 JEFFERSON AVE, MOUNT VERNON, IL 62864-4330
(618) 244-2861
(618) 244-2393
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
0039826
IL
Other
Enumeration date
08/16/2005
Last updated
08/22/2020
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