Provider Demographics
NPI:1740628155
Name:MCCALL ADULT DAYCARE CENTER, INC
Entity type:Organization
Organization Name:MCCALL ADULT DAYCARE CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:RN MSN
Authorized Official - Phone:217-446-9000
Mailing Address - Street 1:1225 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-3029
Mailing Address - Country:US
Mailing Address - Phone:217-446-9000
Mailing Address - Fax:
Practice Address - Street 1:1225 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-3029
Practice Address - Country:US
Practice Address - Phone:217-446-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility