Organization · Type 2 NPI
Penta Nascent Corporation
Intellectual Disabilities Intermediate Care Facility · Salem, IL
NPI number
1467670109
Active
Practice location
301 Roddy Rd
Salem, IL 62881-3836
Mailing address
PO Box 1690
Centralia, IL 62801-9124
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | 0036004 (IL) |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
About NPI 1467670109
Penta Nascent Corporation's National Provider Identifier is 1467670109, issued on Apr 20, 2007. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Salem, IL. The record was last updated on Aug 22, 2020.