NPI 1831248228

Illinois Veterans Home at Manteno

Organisation Physical Disabilities Residential Treatment Facility Manteno, IL

Practice location

Address: 1 Veterans Dr, Manteno, IL 60950-9466
Phone: (815) 468-6581
Fax: (815) 468-7001
Mailing address: 1 Veterans Dr Bldg A-2m, Manteno, IL 60950-9466

Authorised official

Name: Reginald L Booker
Title: Administrator
Phone: (815) 468-6581

Registered specialties (3)

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence 0042218 (IL)

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Adult Care Home Facility

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence 0042218 (IL)

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Durable Medical Equipment & Medical Supplies

Suppliers Taxonomy 332B00000X

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Registry record

NPI: 1831248228
Entity type: Organization
NPI issued: 9 Jan 2007
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.