Organization
RAVE RESIDENTIAL SERVICES, INC.
Active
Parent organization
RAVE RESIDENTIAL SERVICES, INC.
Other names
Peachtree Estates
Organization subpart
Yes
Provider details
NPI number
Legal business name
RAVE RESIDENTIAL SERVICES, INC.
Authorized official
MR. GARY L GRIFFITH L.N.H.A. (ADMINISTRATOR)
(618) 833-5344
Entity
Organization
Contact information
Practice address
1370 STATE ROUTE 127 S, JONESBORO, IL 62952-2488
(618) 833-3235
(618) 833-3237
Mailing address
1390 STATE ROUTE 127 S, JONESBORO, IL 62952-2488
(618) 833-5344
(618) 833-8217
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0040626
IL
Other
Enumeration date
08/27/2007
Last updated
04/20/2008
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