Jack Mabley Developmental Center in Dixon - Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Jack Mabley Developmental Center - NPI 1528103140
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 1528103140. 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 | 1528103140 |
|---|---|
| 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. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1376525204 | IL | CENTER NPI NUMBER |
Post Comment/ Review Below
What is the Jack Mabley Developmental Center's unique identification number?
The Jack Mabley Developmental Center has been assigned the NPI (National Provider Identifier) Number 1528103140 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete address where Jack Mabley Developmental Center is physically located?
The Jack Mabley Developmental Center is situated at the following address: 1120 Washington Ave, Dixon, IL 610211258.
What is Jack Mabley Developmental Center's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Jack Mabley Developmental Center is Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the taxonomy classification code that categorizes this area of expertise is 320600000X.
When did Jack Mabley Developmental Center receive its 1528103140 assignment?
The Jack Mabley Developmental Center was assigned its 1528103140 on 2007-02-21, which is the date when this unique identifier was issued to the organization.
As of what date were the Jack Mabley Developmental Center's details last updated?
The information pertaining to the Jack Mabley Developmental Center, including its address, specialty, and other details, was most recently updated on 2022-07-21.
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