Mt Vernon Countryside Manor

LBN: Palladian Mt Vernon Snf Llc
Mt Vernon Countryside Manor is an health care organization with primary practice located at 606 E Il Highway 15 , Mount Vernon IL 62864-5072. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Palladian Mt Vernon Snf Llc can be contacted via phone (618) 242-1800, or through Mills, Michael Jason via phone (314) 566-0459.

Contact Information

Primary practice address
606 E Il Highway 15 Mount Vernon IL 62864-5072
Phone: (618) 242-1800
Fax: (618) 242-9080
Website:
Map and Directions
Authorized official contact:
Name: Mills, Michael Jason
Phone: (314) 566-0459

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 1656261 Illinois

Profile Details

NPI number 1033107248
LBN Legal business name Palladian Mt Vernon Snf Llc
DBA Doing business as Mt Vernon Countryside Manor
Authorized official Mills, Michael Jason
Entity Organization
Organization subpart 1 No
Enumeration date Oct 11th, 2005
Last updated Mar 18th, 2024 - about 2 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 1033107248 NPPES
Illinois MEDICAID 3712399286286401

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