Organization
J & J MAUPIN GROUP HOMES INC.
Active
Other names
North Kickapoo
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY RAY MAUPIN (PRESIDENT)
(217) 422-6361
Entity
Organization
Contact information
Practice address
5310 E WILLIAM STREET RD, DECATUR, IL 62521-1874
(217) 422-6361
(217) 422-6365
Mailing address
5310 E WILLIAM STREET RD, DECATUR, IL 62521-1874
(217) 422-6361
(217) 422-6365
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0047290
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6011472
—
IL
Enumeration date
04/12/2007
Last updated
08/22/2020
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