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General NPI Number Information
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NPI Number | 1770570418
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Entity Type | Organization
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Legal Business Name | REHAB & CARE CENTER OF JACKSON COUNTY
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 01/20/2012
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Provider Practice Location Address
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Address Line | 1441 N 14TH ST
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City | MURPHYSBORO
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State | IL
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Zip | 62966-2982
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Country | US
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Telephone | 618-684-2136
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Fax | 618-684-5710
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Provider Business Mailing Address
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Address Line | 1441 N 14TH ST
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City | MURPHYSBORO
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State | IL
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Zip | 62966-2982
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Country | US
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Telephone | 618-684-2136
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Fax | 618-684-5710
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MERLE K TAYLOR
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Credential |
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Telephone | 618-684-2136
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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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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 145395
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License Number State | IL
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