NPI 1114142049

Crescent Development Group, INC.

Organisation Adult Care Home Facility Energy, IL

Practice location

Address: 204 Walnut St, Energy, IL 62933
Phone: (618) 988-1702
Fax: (618) 942-3345
Mailing address: 15755 Nixon Rd, Nashville, IL 62263-4815

Authorised official

Name: Jane M Dodson
Title: Vice President
Phone: (618) 327-9846

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence 01S002 (IL)

Other Custodial Care Facility providers in Illinois →

Registry record

NPI: 1114142049
Entity type: Organization
NPI issued: 16 Apr 2007
Record last updated: 22 Aug 2020

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.