Organization
DEVELOPMENTAL PLANNING & SERVICES INC
Active
Other names
OAK TERRACE
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS K HEADLEE (PRESIDENT)
(618) 244-7701
Entity
Organization
Contact information
Practice address
4219 LINCOLNSHIRE DR, MOUNT VERNON, IL 62864-2157
(618) 242-2117
(618) 242-9770
Mailing address
PO BOX 2369, MOUNT VERNON, IL 62864-0046
(618) 244-7701
(618) 244-7704
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0030866
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0030866
LG TERM CARE ICF DD 16
IL
01
—
14G108
PROVIDER IDENTIFICATION #
IL
01
—
6006803
FACILITY ID
IL
Enumeration date
01/18/2007
Last updated
11/17/2008
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