Provider Demographics
NPI:1104252444
Name:CJC MANAGEMENT CORPORATION
Entity type:Organization
Organization Name:CJC MANAGEMENT CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NUELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-821-9539
Mailing Address - Street 1:PO BOX 771
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-0771
Mailing Address - Country:US
Mailing Address - Phone:217-821-9539
Mailing Address - Fax:
Practice Address - Street 1:700 N HENRIETTA ST
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-1720
Practice Address - Country:US
Practice Address - Phone:217-821-9539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities