Provider Demographics
NPI:1861561995
Name:MACON RESOURECES, INC
Entity type:Organization
Organization Name:MACON RESOURECES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMM LIVING SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-875-8889
Mailing Address - Street 1:2121 HUBBARD AVE
Mailing Address - Street 2:P.O. BOX 2760
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-2876
Mailing Address - Country:US
Mailing Address - Phone:217-875-8889
Mailing Address - Fax:217-875-8899
Practice Address - Street 1:2121 HUBBARD AVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-2876
Practice Address - Country:US
Practice Address - Phone:217-875-8889
Practice Address - Fax:217-875-8899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services