Organization · Type 2 NPI
Covenant Care of Jacksonville LLC
Nursing Facility/Intermediate Care Facility · Jacksonville, IL
Practice location
1500 West Walnut Street
Jacksonville, IL 62650-1134
Fax (217) 243-2915
Mailing address
1200 Mountain Creek Road, Suite 350
Chattanooga, TN 37405-6103
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nursing Facility/Intermediate Care Facility Primary | 313M00000X | 1764855 (IL) |
| Skilled Nursing Facility | 314000000X | 0047852 (IL) |
Nursing Facility/Intermediate Care Facility: An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical conditi…
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About NPI 1396811550
Covenant Care of Jacksonville LLC's National Provider Identifier is 1396811550, issued on Nov 28, 2006. The primary taxonomy on file is Nursing Facility/Intermediate Care Facility (313M00000X), and the practice location is in Jacksonville, IL. The record was last updated on Jul 19, 2007.