Organization · Type 2 NPI
Patterson House, Inc.
Intellectual Disabilities Intermediate Care Facility · Canton, IL
NPI number
1548433154
Active
Practice location
1577 E Myrtle St
Canton, IL 61520-1520
Fax (309) 647-0440
Mailing address
PO Box 25527
Decatur, IL 62525-5527
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | 0039354 (IL) |
| Non-emergency Medical Transport (VAN) | 343900000X | 0039354 (IL) |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
About NPI 1548433154
Patterson House, Inc.'s National Provider Identifier is 1548433154, issued on Apr 4, 2008. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Canton, IL. The record was last updated on Jun 24, 2008.