Brethren Home

Organization Active NPI Private Vehicle · Mount Morris, IL

NPI 1548412976 · NPPES record last updated Jan 20, 2009

Key facts

NPI
1548412976
Entity type
Organization (NPI type 2)
Primary specialty
Private Vehicle 347C00000X
Legal business name
BRETHREN HOME
Practice address
414 S Wesley Ave
Mount Morris, IL 61054-1428
Phone
(815) 734-4103
Fax
(815) 734-7318
NPI assigned
Oct 16, 2008
Organization subpart
No

Authorized official

Name
Ms. Carol A Davis, MBA NHA
Title
Ceo/Administrator
Phone
(815) 734-4103

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Brethren Home (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X Yes

Addresses

Primary practice location

414 S Wesley Ave
Mount Morris, IL 61054-1428

Mailing address

414 S Wesley Ave
Mount Morris, IL 61054-1428
Phone (815) 734-4103

Other names

  • PINECREST MANOR Doing business as

Other providers in Mount Morris, IL

All providers in Mount Morris, IL · Private Vehicle in Illinois

Sources for this page

Verify at the official NPI Registry.