Provider Demographics
NPI:1528419769
Name:WEBER CARE CORPORATION
Entity Type:Organization
Organization Name:WEBER CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTATOR
Authorized Official - Prefix:
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:217-522-8406
Mailing Address - Street 1:2520 SAINT JAMES RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62707-9736
Mailing Address - Country:US
Mailing Address - Phone:217-522-8406
Mailing Address - Fax:217-522-8406
Practice Address - Street 1:2520 SAINT JAMES RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62707-9736
Practice Address - Country:US
Practice Address - Phone:217-522-8406
Practice Address - Fax:217-522-8406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2000586251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services