NPI 1386708568

Illinois Veterans Home at Quincy

Organisation Physical Disabilities Residential Treatment Facility Quincy, IL

Practice location

Address: 1707 N 12th St, Quincy, IL 62301-1355
Phone: (217) 222-8641
Fax: (217) 222-8578
Mailing address: 1707 N 12th St Bldg 29m, Quincy, IL 62301-1355

Authorised official

Name: Bruce L Vaca
Title: Administrator
Phone: (217) 222-8641

Registered specialties (3)

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence 44107 (IL)

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Adult Care Home Facility

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence 0044107 (IL)

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Durable Medical Equipment & Medical Supplies

Suppliers Taxonomy 332B00000X

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Registry record

NPI: 1386708568
Entity type: Organization
NPI issued: 21 Dec 2006
Record last updated: 15 Jul 2010

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.