Spring Creek Terrace

LBN: Joe Jac Corp.
Spring Creek Terrace is an health care organization with primary practice located at 5310 E William Street Rd , Decatur IL 62521-1874. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Joe Jac Corp. can be contacted via phone (217) 422-6361, or through Maupin, Jeremy Ray via phone (217) 422-6361.

Contact Information

Primary practice address
5310 E William Street Rd Decatur IL 62521-1874
Phone: (217) 422-6361
Fax: (217) 422-6365
Website:
Map and Directions
Authorized official contact:
Name: Maupin, Jeremy Ray
Phone: (217) 422-6361

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 0045955 Illinois

Profile Details

NPI number 1285857284
LBN Legal business name Joe Jac Corp.
DBA Doing business as Spring Creek Terrace
Authorized official Maupin, Jeremy Ray
Entity Organization
Organization subpart 1 No
Enumeration date Apr 10th, 2007
Last updated Jun 18th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285857284 NPPES
Illinois MEDICAID 6012314

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