Active NPI
JJR Enterprises Inc
Doing business as Stuart Estates
- Intellectual Disabilities Intermediate Care Facility
- McLeansboro, IL
National Provider Identifier
1255405056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual Disabilities Intermediate Care Facility
- License
- 0043802
- Legal business name
- JJR ENTERPRISES INC
- Doing business as
- Stuart Estates
- Practice address
- 13 Northbrook Dr
MC Leansboro, IL 62859-1342 - Phone
- (618) 643-3566
- Fax
- (618) 643-2577
- NPI assigned
- Nov 20, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Beth A Quick
- Title
- Vice President
- Phone
- (618) 244-7701
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 0043802 | IL | Primary |
Addresses
Primary practice location
13 Northbrook Dr
MC Leansboro, IL 62859-1342
Mailing address
PO Box 705
Mount Vernon, IL 62864-0015
Phone (618) 244-7701
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0043802 | Other | IL | LG TERM CARE ICF DD 16 |
| 6012272 | Other | IL | FACILITY ID |
| 14G222 | Other | IL | PROVIDER IDENTIFICATION # |
Other names 1
- STUART ESTATES
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1255405056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 705",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628640015",
"telephone_number": "618-244-7701",
"fax_number": "618-244-7704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 NORTHBROOK DR",
"city": "MC LEANSBORO",
"state": "IL",
"postal_code": "628591342",
"telephone_number": "618-643-3566",
"fax_number": "618-643-2577"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JJR ENTERPRISES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-20",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "QUICK",
"authorized_official_first_name": "BETH",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "618-244-7701"
},
"taxonomies": [
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": "IL",
"license": "0043802",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LG TERM CARE ICF DD 16",
"identifier": "0043802",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FACILITY ID",
"identifier": "6012272",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER IDENTIFICATION #",
"identifier": "14G222",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "STUART ESTATES",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in McLeansboro, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.