Jacksonville Developmental Center
LBN: Bushnell Dix Hill Jones 694110
Jacksonville Developmental Center is an health care organization with primary practice located at 1201 S Main St , Jacksonville IL 62650-3339. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty.
Bushnell Dix Hill Jones 694110 can be contacted via phone (217) 479-2120, or through Pennell, Susie via phone (217) 479-2120.
Contact Information
Primary practice address
1201 S Main St
Jacksonville IL 62650-3339
Phone: (217) 479-2120
Fax: (217) 243-8920
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 320600000X |
Profile Details
| NPI number | 1154465243 |
|---|---|
| LBN Legal business name | Bushnell Dix Hill Jones 694110 |
| DBA Doing business as | Jacksonville Developmental Center |
| Authorized official | Pennell, Susie |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 20th, 2007 |
| Last updated | Aug 22nd, 2020 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154465243 | NPPES |
| Illinois | MEDICAID | 694110 |
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