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General NPI Number Information
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NPI Number | 1457575243
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Entity Type | Organization
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Legal Business Name | DEVELOPMENTAL MANAGEMENT, INC.
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 618 W GOODNER ST
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City | NASHVILLE
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State | IL
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Zip | 62263-1009
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Country | US
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Telephone | 618-327-3911
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Fax | 618-327-3645
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Provider Business Mailing Address
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Address Line | 15755 NIXON RD
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City | NASHVILLE
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State | IL
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Zip | 62263-4815
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Country | US
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Telephone | 618-327-9846
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Fax | 618-327-9845
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MS. JANE M DODSON
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Credential |
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Telephone | 618-327-9846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 0039552
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License Number State | IL
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