Organization
PATTERSON HOUSE, INC.
Active
Other names
Carlinville Estates
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICKI M PALMER (RESIDENTIAL SERVICE DIRECTOR)
(217) 854-9443
Entity
Organization
Contact information
Practice address
1221 S PLUM ST, CARLINVILLE, IL 62626-2048
(217) 854-9443
(217) 854-9324
Mailing address
PO BOX 25527, DECATUR, IL 62525-5527
(217) 422-6510
(217) 422-6819
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0039962
IL
343900000X
Non-emergency Medical Transport (VAN)
5546PT
IL
Other
Enumeration date
02/08/2008
Last updated
06/24/2008
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