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General NPI Number Information
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NPI Number | 1578558300
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Entity Type | Organization
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Legal Business Name | UNLIMITED DEVELOPMENT, INC.
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 07/17/2009
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Provider Practice Location Address
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Address Line | 1251 N STATE ST
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City | JERSEYVILLE
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State | IL
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Zip | 62052-1169
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Country | US
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Telephone | 618-498-6441
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Fax | 618-498-9025
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Provider Business Mailing Address
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Address Line | 1251 N STATE ST
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City | JERSEYVILLE
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State | IL
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Zip | 62052-1169
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Country | US
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Telephone | 618-498-6441
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Fax | 618-498-9025
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Authorized Official
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Title or Position | CFO
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Name | MR. RONALD J WILSON
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Credential |
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Telephone | 309-343-1550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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