Organization
JACK MABLEY DEVELOPMENTAL CENTER
Active
Other names
Stonebridge Home
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON DEBERRY (CENTER DIRECTOR)
(815) 288-8330
Entity
Organization
Contact information
Practice address
1120 WASHINGTON AVE, DIXON, IL 61021-1258
(815) 288-8331
(815) 288-7275
Mailing address
1120 WASHINGTON AVE, DIXON, IL 61021-1258
(815) 288-8331
(815) 288-7275
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376525204
CENTER NPI NUMBER
IL
Enumeration date
02/21/2007
Last updated
07/21/2022
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