Organization
THE MANOR AT JERSEYVILLE GLEN, LP
Active
Other names
Blackberry Cottage
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA ANN RAPP (CHIEF OPERATING OFFICER)
(618) 594-8581
Entity
Organization
Contact information
Practice address
904B ESTATES DR, JERSEYVILLE, IL 62052-2377
(618) 639-9710
(618) 639-9715
Mailing address
904B ESTATES DR, JERSEYVILLE, IL 62052-2377
(618) 639-9710
(618) 639-9715
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/06/2020
Last updated
10/06/2020
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