NPI 1013182807

Hickory Estates

Organisation Intellectual Disabilities Intermediate Care Facility Sumner, IL

Practice location

Address: 310 Otha Street, Sumner, IL 62466-0164
Phone: (618) 936-2004
Fax: (618) 936-2556
Mailing address: 310 Otha Street, Sumner, IL 62466

Authorised official

Name: Peter Michael Narish
Title: Administrator
Phone: (618) 936-2004

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 0030510 (IL)

Other Intermediate Care Facility, Intellectual Disabilities providers in Illinois →

Registry record

NPI: 1013182807
Entity type: Organization
NPI issued: 23 Apr 2008
Record last updated: 23 Apr 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.