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NPI Code Detail

MEDICARE: WEBER CARE CORPORATION

MEDICARE: WEBER CARE CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency2000586IL

General Provider Information

NPI Number : 1528419769
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEBER CARE CORPORATION
Provider Business Mailing Address
First Line : 2520 SAINT JAMES RD
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62707-9736
Country : US
Telephone Number : 217-522-8406
Fax Number : 217-522-8406
Provider Business Practice Location Address
First Line : 2520 SAINT JAMES RD
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62707-9736
Country : US
Telephone Number : 217-522-8406
Fax Number : 217-522-8406
Authorized Official
Title or Position : ADMINISTATOR
Name : CONSTANCE J BAKER
Credential : NHA
Telephone Number : 217-522-8406
Provider Enumeration Date : 06/29/2016
Last Update Date : 06/29/2016

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Directions to “WEBER CARE CORPORATION ” Practice Location

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