Organization
CARAVILLA RESIDENTIAL CENTERS, INC
Active
Other names
JEFFERSONIAN HEALTH CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL F FLANAGAN (RECEIVER FOR, CORPORTATE ATTORNEY)
(816) 444-0900
Entity
Organization
Contact information
Practice address
1700 WHITE ST, MOUNT VERNON, IL 62864-4349
(618) 242-4075
(618) 242-4092
Mailing address
1700 WHITE ST, MOUNT VERNON, IL 62864-4349
(618) 242-4075
(618) 242-4092
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0039818
IL
Other
Enumeration date
07/27/2005
Last updated
08/22/2020
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