Organization
PATTERSON HOUSE, INC
Active
Other names
Patterson House
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VERONIKA WILSON QMRP (RSD)
(217) 728-4357
Entity
Organization
Contact information
Practice address
307 E JEFFERSON ST, SULLIVAN, IL 61951-2029
(217) 728-4357
(217) 728-9017
Mailing address
PO BOX 25527, DECATUR, IL 62525-5527
(217) 422-6510
(217) 422-6819
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0037341
IL
343800000X
Secured Medical Transport (VAN)
0037341
IL
Other
Enumeration date
04/08/2008
Last updated
06/24/2008
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