Joe Jac Corp. in Decatur - Intermediate Care Facility, Intellectual Disabilities
Joe Jac Corp. - NPI 1285857284
Joe Jac Corp. is a Intermediate Care Facility, Intellectual Disabilities in Decatur, Illinois. Joe Jac Corp. practices all healthcare services and medical treatments related to Intermediate Care Facility, Intellectual Disabilities. The NPI Number for Joe Jac Corp. is 1285857284. The last update date is 2008-06-18.
Joe Jac Corp.'s current location address is 5310 E William Street Rd, Decatur, Illinois. You can contact this provider via phone number 2174226361 and fax number 2174226365. The mailing address for Joe Jac Corp. is 5310 E William Street Rd, Decatur, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Joe Jac Corp. |
|---|---|
| Address | 5310 E William Street Rd, Decatur, Illinois |
| Phone Number | 2174226361 |
| Fax Number | 2174226365 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Maupin Ray Jeremy |
| Telephone Number | 2174226361 |
NPI Number Detail
| NPI Number | 1285857284 |
|---|---|
| Provider Enumeration Date | 2007-04-10 |
| Last Updated Date | 2008-06-18 |
Provider Mailing Address Detail
| Address | 5310 E William Street Rd |
|---|---|
| City | Decatur |
| State | Illinois (IL) |
| Post Code | 625211874 |
| Phone Number | 2174226361 |
| Fax Number | 2174226365 |
Provider's Primary Taxonomy Detail
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
|---|---|
| Taxonomy | 315P00000X |
| Licence No | 45955 |
|
Definition: An intermediate care facility providing services for individuals with intellectual disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 6012314 | IL | -- |
Post Comment/ Review Below
What is the Joe Jac Corp.'s unique identification number?
The Joe Jac Corp. has been assigned the NPI (National Provider Identifier) Number 1285857284 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Joe Jac Corp. located?
The Joe Jac Corp. is located at 5310 E William Street Rd, Decatur, IL 625211874.
What is Joe Jac Corp.'s primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Joe Jac Corp. is Intermediate Care Facility, Intellectual Disabilities, and the corresponding taxonomy classification code for this specialized field is 315P00000X.
On what date did the Joe Jac Corp. receive its 1285857284 assignment from the Centers for Medicare & Medicaid Services?
The Joe Jac Corp. was assigned its 1285857284 by the Centers for Medicare & Medicaid Services on 2007-04-10.
When was the information related to Joe Jac Corp. most recently updated or refreshed?
The details pertaining to the Joe Jac Corp., including its address, specialty, and other relevant information, were last updated or refreshed on 2008-06-18.
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