Covenant Care Of Jacksonville Llc, NPI 1396811550
Nursing Facility/Intermediate Care Facility in Jacksonville, IL, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1396811550 |
| NPI Entity Type | Organization |
| Provider Name |
Covenant Care Of Jacksonville Llc
Doing Business As |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Provider Location Address | 1500 West Walnut Street, Jacksonville, IL, US |
| Provider Mailing Address | 1200 Mountain Creek Road, Suite 350, Chattanooga, TN, US, 374056103 |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | Gary L Potts |
| Official Position | MANAGER |
| Phone | 423-870-3153 |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Nursing Facility/Intermediate Care Facility |
| Classification | |
| Group | |
| License No. | 1764855 |
| License State | IL |
| Description | An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| 0047852 | IL | No |
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