NPI 1003068776

Menard Convalescent Center, INC

Organisation Skilled Nursing Facility Petersburg, IL

Practice location

Address: 120 W Antle St, Petersburg, IL 62675-1035
Phone: (217) 632-2249
Fax: (217) 632-7810
Mailing address: 2653 W Lawrence Ave STE B, Springfield, IL 62704-1115

Authorised official

Name: Jerry W Jennings
Title: Controller
Phone: (217) 787-8530

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence 0003020 (IL)

Other Skilled Nursing Facility providers in Illinois →

Registry record

NPI: 1003068776
Entity type: Organization
NPI issued: 14 Oct 2008
Record last updated: 14 Oct 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.