Mulberry Manor, Inc.

NPI #1164646550 in Anna, Illinois

Provider Information

NPI Number: 1164646550
Entity Type: Organization
Organization Name: Mulberry Manor, Inc.
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Apr 13, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 612 E DAVIE
City: Anna
State: Illinois
ZIP Code: 62906-0088
Phone: (618) 833-6012

Authorized Official

Name: JOANN KELLER
Title: ADMINISTRATOR
Phone: (618) 833-6012

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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