Covenant Care of Jacksonville LLC
NPI #1396811550 in Jacksonville, Illinois
Provider Information
- NPI Number
- 1396811550
- Entity Type
- Organization
- Organization Name
- Covenant Care of Jacksonville LLC
- Primary Specialty
- Nursing Facility/Intermediate Care Facility
- Enumeration Date
- Nov 28, 2006
- Last Updated
- Jul 19, 2007
Practice Location
- Address
- 1500 WEST WALNUT STREET
- City
- Jacksonville
- State
- Illinois
- ZIP Code
- 62650-1134
- Phone
- (217) 245-4183
Authorized Official
- Name
- GARY L POTTS
- Title
- MANAGER
- Phone
- (423) 870-3153
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
| Nursing Facility/Intermediate Care Facility |
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