Healthcare Provider Details

I. General information

NPI: 1841846607
Provider Name (Legal Business Name): POINTE AT JACKSONVILLE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 JACKSONVILLE PL
JACKSONVILLE IL
62650-3716
US

IV. Provider business mailing address

20 JACKSONVILLE PL
JACKSONVILLE IL
62650-3716
US

V. Phone/Fax

Practice location:
  • Phone: 815-416-6206
  • Fax: 815-416-6201
Mailing address:
  • Phone: 815-416-6206
  • Fax: 815-416-6201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL STEIN
Title or Position: OWNER
Credential:
Phone: 815-416-6206