Provider Demographics
NPI:1235296690
Name:RINCKER RESIDENTIAL SERVICES, INC.
Entity Type:Organization
Organization Name:RINCKER RESIDENTIAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:GILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-945-2091
Mailing Address - Street 1:900 E. CORPORATION
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:62417
Mailing Address - Country:US
Mailing Address - Phone:618-945-2091
Mailing Address - Fax:
Practice Address - Street 1:1216 WILLOW DR
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:IL
Practice Address - Zip Code:62450-2483
Practice Address - Country:US
Practice Address - Phone:618-395-7190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL97S015315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0782OtherPROGRAM CODE