Provider Demographics
NPI:1528230455
Name:FRANCES HOUSE INC
Entity Type:Organization
Organization Name:FRANCES HOUSE INC
Other - Org Name:HALLAM TERRACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-343-1550
Mailing Address - Street 1:285 SOUTH FARNHAM STREET
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-5323
Mailing Address - Country:US
Mailing Address - Phone:309-343-1550
Mailing Address - Fax:309-343-6318
Practice Address - Street 1:1108 TAYLOR STREET
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61101-5861
Practice Address - Country:US
Practice Address - Phone:815-963-0570
Practice Address - Fax:815-963-0563
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCES HOUSE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-01
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL33902315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========013Medicaid