Calvin Johnson Care Center

LBN: Eldercare, Inc.
Calvin Johnson Care Center is an health care organization with primary practice located at 727 North 17Th Street , Belleville IL 62226-6599. The organization recently has 3 registered licenses in different health care specialties including Laboratories / Clinical Medical Laboratory, Nursing & Custodial Care Facilities / Skilled Nursing Facility, Suppliers / Oxygen Equipment & Supplies. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. Eldercare, Inc. can be contacted via phone (618) 234-3323, or through Wolf, Steven C. via phone (618) 234-2273.

Contact Information

Primary practice address
727 North 17Th Street Belleville IL 62226-6599
Phone: (618) 234-3323
Fax: (618) 234-9477
Website:
Map and Directions
Authorized official contact:
Name: Wolf, Steven C.
Phone: (618) 234-2273

Health care specialties

SpecialtyCodeLicense #State
Laboratories / Clinical Medical Laboratory 291U00000X 1400434197 Illinois
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 0023309 Illinois
Suppliers / Oxygen Equipment & Supplies 332BX2000X

Profile Details

NPI number 1902051154
LBN Legal business name Eldercare, Inc.
DBA Doing business as Calvin Johnson Care Center
Authorized official Wolf, Steven C.
Entity Organization
Organization subpart 1 No
Enumeration date Dec 1st, 2008
Last updated Aug 17th, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902051154 NPPES
Missouri MEDICAID 103025508
Missouri Other V255P(657)0911

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