RAVE RESIDENTIAL SERVICES INC NPI 1609069335

NPI Information

  • NPI: 1609069335
  • Provider Name: RAVE RESIDENTIAL SERVICES, INC
  • Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
  • Entity Type: Organization
  • Doing Business As: ORCHARD COURT
  • Address: 1430 STATE ROUTE 127 S
    JONESBORO, IL
    ZIP 62952
  • Phone: (618) 833-8033

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NPI Details

RAVE RESIDENTIAL SERVICES, INC is an intermediate care facility mentally retarded in Jonesboro, IL. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. RAVE RESIDENTIAL SERVICES, INC NPI is 1609069335. The provider is registered as an organization entity type.
The provider Is Doing Business As Orchard Court.

The provider's business location address is:

1430 STATE ROUTE 127 S
JONESBORO, IL
ZIP 62952-489
Phone: (618) 833-8033
Fax: (618) 833-8035

The provider's authorized official is Gary L Griffith .
The authorized official title is Administrator and has the following contact phone number (618) 833-5344.

The enumeration date for this NPI number is 8/27/2007 and was last updated on 4/20/2008.

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
1315P00000XIntermediate Care Facility, Intellectual Disabilities0040970ILLINOISYes

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
1=========002MEDICAIDILLINOIS

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: 11/21/2025

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