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JACK MABLEY DEVELOPMENTAL CENTER NPI 1528103140


NPI Information

NPI: 1528103140
Provider Name: JACK MABLEY DEVELOPMENTAL CENTER

Other Name: BROWNING HOME

Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
1120 WASHINGTON AVE
DIXON, IL
ZIP 61021
Phone: (815) 288-8331
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JACK MABLEY DEVELOPMENTAL CENTER is a residential treatment facility, intellectual and/or developmental disabilities in Dixon, IL. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. JACK MABLEY DEVELOPMENTAL CENTER NPI is 1528103140. The provider is registered as an organization entity type.
The provider Other Name Is Browning Home.

The provider's business location address is:

1120 WASHINGTON AVE
DIXON, IL
ZIP 61021-258
Phone: (815) 288-8331
Fax: (815) 288-7275

The provider's authorized official is Sharon Deberry .
The authorized official title is Center Director and has the following contact phone number (815) 288-8330.

The enumeration date for this NPI number is 2/21/2007 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11376525204OTHERILLINOISCENTER NPI NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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