Organization
JACKSONVILLE 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
1517 W WALNUT ST, JACKSONVILLE, IL 62650-1133
(217) 243-6451
(217) 243-8295
Mailing address
2653 W LAWRENCE, SUITE B, SPRINGFIELD, IL 62704
(217) 787-8530
(217) 787-9840
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0020131
IL
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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