Jack Mabley Developmental Center in Dixon - Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Jack Mabley Developmental Center - NPI 1285779892
Jack Mabley Developmental Center is a Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Dixon, Illinois. Jack Mabley Developmental Center practices all healthcare services and medical treatments related to Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Jack Mabley Developmental Center is 1285779892. The last update date is 2022-07-21.
Jack Mabley Developmental Center's current location address is 1120 Washington Ave, Dixon, Illinois. You can contact this provider via phone number 8152888331 and fax number 8152887275. The mailing address for Jack Mabley Developmental Center is 1120 Washington Ave, Dixon, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Jack Mabley Developmental Center |
|---|---|
| Address | 1120 Washington Ave, Dixon, Illinois |
| Phone Number | 8152888331 |
| Fax Number | 8152887275 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CENTER DIR |
|---|---|
| Authorized Official Name | Deberry Sharon |
| Telephone Number | 8152888330 |
NPI Number Detail
| NPI Number | 1285779892 |
|---|---|
| Provider Enumeration Date | 2007-02-21 |
| Last Updated Date | 2022-07-21 |
Provider Mailing Address Detail
| Address | 1120 Washington Ave |
|---|---|
| City | Dixon |
| State | Illinois (IL) |
| Post Code | 610211258 |
| Phone Number | 8152888331 |
| Fax Number | 8152887275 |
Provider's Primary Taxonomy Detail
| Speciality | Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|---|
| Taxonomy | 320600000X |
|
Definition: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1376525204 | IL | CENTER NPI NUMBER |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Jack Mabley Developmental Center by the Centers for Medicare & Medicaid Services?
The Jack Mabley Developmental Center has been issued the NPI (National Provider Identifier) 1285779892 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Jack Mabley Developmental Center is physically located?
The Jack Mabley Developmental Center is physically situated at the following address: 1120 Washington Ave, Dixon, IL, 610211258.
What is the Jack Mabley Developmental Center's specialty and taxonomy code?
The Jack Mabley Developmental Center's specialty is Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code is 320600000X.
On what date did the Jack Mabley Developmental Center receive its 1285779892 assignment from the Centers for Medicare & Medicaid Services?
The Jack Mabley Developmental Center was assigned its 1285779892 by the Centers for Medicare & Medicaid Services on 2007-02-21.
As of what date were the details related to Jack Mabley Developmental Center most recently updated or revised?
The information pertaining to Jack Mabley Developmental Center, including its address, specialty, and other relevant details, was last updated or revised on 2022-07-21.