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Contact Information

CARAVILLA RESIDENTIAL CENTERS, INC
5 DOCTORS PARK RD
MOUNT VERNON, IL62864-6224
 Phone: 618-242-1064
 Fax: 618-242-7559
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for CARAVILLA RESIDENTIAL CENTERS, INC

NPI # 1659363661
LBN Legal business name CARAVILLA RESIDENTIAL CENTERS, INC
Authorized official MICHAEL FLANAGAN - (CORPORATE ATTORNEY)
Entity Organization
Organization subpart 1 No
Enumeration date 08/16/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers
IL License # 0039800
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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