JJR Enterprises Inc

Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Fairfield, IL

NPI 1245303528 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1245303528
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
License
00143828 (IL)
Legal business name
JJR ENTERPRISES INC
Practice address
813 W Center St
Fairfield, IL 62837-1403
Phone
(618) 842-2260
Fax
(618) 842-4228
NPI assigned
Nov 16, 2006
Organization subpart
No

Authorized official

Name
Beth A Quick
Title
Vice President
Phone
(618) 244-7701

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 00143828 IL Yes

Addresses

Primary practice location

813 W Center St
Fairfield, IL 62837-1403

Mailing address

PO Box 705
Mount Vernon, IL 62864-0015
Phone (618) 244-7701

Other identifiers

IdentifierTypeStateIssuer
14G276OtherILPROVIDER IDENTIFICATION #
0043828OtherILLG TERM CARE ICF DD 16
6012983OtherILFACILITY ID

Other names

  • TRAFFORD ESTATES Doing business as

Other providers in Fairfield, IL

All providers in Fairfield, IL · Intellectual Disabilities Intermediate Care Facility in Illinois

Sources for this page

Verify at the official NPI Registry.