Lebanon Terrace in Lebanon - Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Lebanon Terrace - NPI 1104945716
Lebanon Terrace is a Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Lebanon, Illinois. Lebanon Terrace practices all healthcare services and medical treatments related to Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Lebanon Terrace is 1104945716. The last update date is 2020-08-22.
Lebanon Terrace's current location address is 221 E 3rd St, Lebanon, Illinois. You can contact this provider via phone number 6185374133 and fax number 6185374156. The mailing address for Lebanon Terrace is 221 E 3rd St, Lebanon, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lebanon Terrace |
|---|---|
| Address | 221 E 3rd St, Lebanon, Illinois |
| Phone Number | 6185374133 |
| Fax Number | 6185374156 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | QMRP |
|---|---|
| Authorized Official Name | Jones L Donna |
| Telephone Number | 6185374133 |
NPI Number Detail
| NPI Number | 1104945716 |
|---|---|
| Provider Enumeration Date | 2007-03-28 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 221 E 3rd St |
|---|---|
| City | Lebanon |
| State | Illinois (IL) |
| Post Code | 622541668 |
| Phone Number | 6185374133 |
| Fax Number | 6185374156 |
Provider's Primary Taxonomy Detail
| Speciality | Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|---|
| Taxonomy | 320600000X |
| Licence No | 38430 |
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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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Post Comment/ Review Below
What is the Lebanon Terrace's 1104945716?
The Lebanon Terrace's NPI (National Provider Identifier) Number is 1104945716. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Lebanon Terrace is geographically located?
The Lebanon Terrace is physically situated at the following location: 221 E 3Rd St, Lebanon, IL, 622541668.
What is the Lebanon Terrace's specialty and taxonomy code?
The Lebanon Terrace's specialty is Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code is 320600000X.
When did the Lebanon Terrace receive its 1104945716?
The Lebanon Terrace was issued its 1104945716 on 2007-03-28, which is the date when the organization was assigned this unique identifier.
As of what date were the Lebanon Terrace's details last updated?
The information pertaining to the Lebanon Terrace, including its address, specialty, and other details, was most recently updated on 2020-08-22.