R&J Enterprises Country Living, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

199400203S Issued in IL

Legal business name

R&J ENTERPRISES COUNTRY LIVING, INC

Practice address

221 East Ave
Anna, IL 62906-1903

Phone

(618) 833-7418

Fax

(618) 833-5400

NPI assigned

Dec 11, 2015

Last updated

Dec 11, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kimberly Cates

Title

Acting Director

Phone

(618) 833-7418

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1508231879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 EAST AVE",
            "city": "ANNA",
            "state": "IL",
            "postal_code": "629061903",
            "telephone_number": "618-833-7418",
            "fax_number": "618-833-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 EAST AVE",
            "city": "ANNA",
            "state": "IL",
            "postal_code": "629061903",
            "telephone_number": "618-833-7418",
            "fax_number": "618-833-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R&J ENTERPRISES COUNTRY LIVING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "CATES",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "ACTING DIRECTOR",
        "authorized_official_telephone_number": "618-833-7418"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "199400203S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Anna, IL
• Providers in Anna, IL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.