JJR Enterprises Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

0039248 Issued in IL

Legal business name

JJR ENTERPRISES INC

Practice address

225 W B St
Belleville, IL 62220-1337

Phone

(618) 234-5657

Fax

(618) 234-4508

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Addresses

Other identifiers 3

Other names 1

• BELLE MANOR Doing business as

Locations

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508939174",
    "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": "225 W B ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201337",
            "telephone_number": "618-234-5657",
            "fax_number": "618-234-4508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JJR ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "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": "0039248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID",
            "identifier": "6014039",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER IDENTIFICATION #",
            "identifier": "14G343",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LG TERM CARE ICF DD 16",
            "identifier": "0039248",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BELLE MANOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Silvia Jeliazkova, MS, CF-SLP
• Michael Jude Jennewein, MD
• Dominique Jennings
• Tyler Marcus Jennings, DO
• Morgan Jetton
• Jennifer R Jobe, CRNA
• Elizabeth Jane Johns, ACNP
• Kris Johnson, RPH
• Lisa Marlow Johnson
• Rebakkah Jerreah Johnson, PHARMD

• All providers in Belleville, IL
• Intellectual Disabilities Intermediate Care Facility in Illinois

• 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.

Verify at the official NPI Registry.