Hickory Estates

NPI #1013182807 in Sumner, Illinois

Provider Information

NPI Number
1013182807
Entity Type
Organization
Organization Name
Hickory Estates
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Apr 23, 2008
Last Updated
Apr 23, 2008

Practice Location

Address
310 OTHA STREET
City
Sumner
ZIP Code
62466-0164
Phone
(618) 936-2004

Authorized Official

Name
MS. PETER MICHAEL NARISH, ADMINISTRATOR
Title
ADMINISTRATOR
Phone
(618) 936-2004

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Intellectual Disabilities

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