THE MANOR AT JERSEYVILLE GLEN, LP (NPI# 1871190504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871190504 |
| Entity Type | Organization |
| Organization Name | THE MANOR AT JERSEYVILLE GLEN, LP |
| Practice Address |
904b Estates Dr Jerseyville IL 62052-2377 |
| Practice Telephone | 6186399710 |
| Practice Fax Number | 6186399715 |
| Mailing Telephone | 6186399710 |
| Mailing Fax Number | 6186399715 |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-10-06 |
| Authorized Official Name | CYNTHIA ANN RAPP (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 6185948581 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Blackberry Cottage | Doing Business As Name - Organization |
| Street Address |
904B ESTATES DR |
| City | JERSEYVILLE |
| State | IL |
| Zip Code | 62052-2377 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396265666 | Lauren Mccarthy | Podiatrist | 400 Maple Summit Rd Suite 200, Jerseyville, IL 62052 | 2017-06-27 |
| 1851757488 | German Insurance Agency | Local Education Agency (LEA) | 850 S State Street, Jerseyville, IL 62052 | 2016-01-12 |
| 1942584230 | Thomas G Honke | Pharmacist | 705 South State, Walgreens, Jerseyville, IL 62052 | 2011-10-05 |
| 1861786493 | Pain Relief Center | Clinic/Center | 903 South State Street, Jerseyville, IL 62052 | 2011-05-31 |
| 1902058845 | Ronald Lee Schroeder | Obstetrics & Gynecology | 1211 West Carpenter, Jerseyville, IL 62052 | 2008-10-22 |
| 1760696116 | Rebecca Elaine Alexander | Massage Therapist | 1301 S State St, Jerseyville, IL 62052 | 2007-05-09 |
| 1205950540 | Charles C Alexander | Chiropractor | 1301 S State, Jerseyville, IL 62052 | 2007-03-19 |
| 1902816358 | Kirk William Schultz | Chiropractor | 519 South State Street, Jerseyville, IL 62052 | 2006-08-08 |
| 1235119652 | Batool N Vali | Obstetrics & Gynecology | 1702 W. County Road, Jerseyville, IL 62052 | 2006-01-20 |
| 1649270729 | Jersey County Health Department | Public Health or Welfare | 1307 State Highway 109, Jerseyville, IL 62052 | 2005-07-29 |
| Find all providers in zip 62052 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336428937 | Jerseyville Estates | Assisted Living Facility | 1210 E Fairground Ave, Jerseyville, IL 62052-1153 | 2011-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861008872 | Franciscan Communities, Inc. | Assisted Living Facility | 15624 Marian Dr, Homer Glen, IL 60491-6271 | 2020-09-16 |
| 1447865118 | Oakley Courts Assisted Living Community | Assisted Living Facility | 3117 W Kunkle Blvd, Freeport, IL 61032-6943 | 2020-09-10 |
| 1083233076 | Marley Oaks Assisted Living Residence | Assisted Living Facility | 12631 187th St, Mokena, IL 60448-8731 | 2020-04-10 |
| 1447884630 | Cedarhurst of Quincy Operator, LLC | Assisted Living Facility | 319 S 48th St, Quincy, IL 62305-0593 | 2020-02-26 |
| 1164055323 | Cye Sullivan Hco, LLC | Assisted Living Facility | 20 Courtyard Blvd, Sullivan, IL 61951-7001 | 2020-02-17 |
| 1255964573 | Cottages At Salem, Inc. | Assisted Living Facility | 339 S Hotze Rd, Salem, IL 62881-6858 | 2020-02-14 |
| 1841821014 | Generations At Oakton Arms, LLC | Assisted Living Facility | 1665 Oakton Pl, Des Plaines, IL 60018-6301 | 2020-01-28 |
| 1710521984 | Cottages At Carlinville, Inc | Assisted Living Facility | 18804 Rt. 4, Carlinville, IL 62626 | 2019-10-31 |
| 1275184889 | The Encore At The Twin Cities | Assisted Living Facility | 101 N Wacker Dr Ste 608, Chicago, IL 60606-1726 | 2019-09-25 |
| 1881103646 | Stonebridge of Gurnee, LLC | Assisted Living Facility | 5980 Washington St, Gurnee, IL 60031-5900 | 2017-09-25 |
| Find all providers with the same taxonomy | ||||
| City | JERSEYVILLE |
| Zip Code | 62052 |
Please comment or provide details below to improve the information on THE MANOR AT JERSEYVILLE GLEN, LP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.