Organization
JJR ENTERPRISES INC
Active
Other names
BELLE MANOR
Organization subpart
No
Provider details
NPI number
Authorized official
BETH A QUICK (VICE PRESIDENT)
(618) 244-7701
Entity
Organization
Contact information
Practice address
225 W B ST, BELLEVILLE, IL 62220-1337
(618) 234-5657
(618) 234-4508
Mailing address
PO BOX 705, MOUNT VERNON, IL 62864-0015
(618) 244-7701
(618) 244-7704
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0039248
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039248
LG TERM CARE ICF DD 16
IL
01
—
14G343
PROVIDER IDENTIFICATION #
IL
01
—
6014039
FACILITY ID
IL
Enumeration date
11/15/2006
Last updated
08/22/2020
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