Organization
ELM CITY REHABILITATION CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS FREDERICK (PRESIDENT CEO)
(217) 245-9504
Entity
Organization
Contact information
Practice address
1314 W WALNUT ST, JACKSONVILLE, IL 62650-1148
(217) 245-9504
Mailing address
1314 W WALNUT ST, JACKSONVILLE, IL 62650-1148
(217) 245-9504
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
04052
IL
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
0517
IL
Other
Enumeration date
03/01/2007
Last updated
09/11/2025
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