NPI 1619012234

Jack Mabley Developmental Center

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Dixon, IL

Practice location

Address: 1120 Washington Ave, Dixon, IL 61021-1258
Phone: (815) 288-8331
Fax: (815) 288-7275

Authorised official

Name: Sharon Deberry
Title: Center Director
Phone: (815) 288-8330

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Illinois →

Registry record

NPI: 1619012234
Entity type: Organization
NPI issued: 21 Feb 2007
Record last updated: 21 Jul 2022

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.