BEVERLY FARM FOUNDATION (NPI# 1174696157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174696157 |
| Entity Type | Organization |
| Organization Name | BEVERLY FARM FOUNDATION |
| Practice Address |
6301 Humbert Rd Godfrey IL 62035-2163 |
| Practice Telephone | 6184660367 |
| Practice Fax Number | 6184663652 |
| Mailing Telephone | 6184660367 |
| Mailing Fax Number | 6184663652 |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2016-08-25 |
| Authorized Official Name | MRS. BRENDA E. MILLER (FINANCE DIRECTOR) |
| Authorized Official Telephone | 6184660367 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 0038604 | IL | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376618082 | Beverly Farm Foundation | Intermediate Care Facility, Mentally Retarded | 212 Bachman Ln, Godfrey, IL 62035-2122 | 2006-11-21 |
| 1093880700 | Beverly Farm Foundation | Intermediate Care Facility, Mentally Retarded | 224 Bachman Ln, Godfrey, IL 62035-2122 | 2006-11-21 |
| 1568537272 | Beverly Farm Foundation | Intermediate Care Facility, Mentally Retarded | 314 Bachman Ln, Godfrey, IL 62035-2123 | 2006-11-21 |
| 1902971617 | Beverly Farm Foundation | Intermediate Care Facility, Mentally Retarded | 320 Bachman Ln, Godfrey, IL 62035-2123 | 2006-11-21 |
| 1710051545 | Beverly Farm Foundation | Intermediate Care Facility, Mentally Retarded | 302 Bachman Ln, Godfrey, IL 62035-2123 | 2006-11-20 |
| 1265506091 | Beverly Farm Foundation | Intermediate Care Facility, Mentally Retarded | 308 Bachman Ln, Godfrey, IL 62035-2123 | 2006-11-20 |
| 1255885414 | Beverly Farm Foundation | Day Training, Developmentally Disabled Services | 6301 Humbert Rd, Godfrey, IL 62035-2163 | 2016-08-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BEVERLY FARM FOUNDATION | 6301 Humbert Rd, Godfrey, IL 62035-2163 |
| Street Address |
6301 HUMBERT RD |
| City | GODFREY |
| State | IL |
| Zip Code | 62035-2163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699234062 | Allie E Thyer | Speech-Language Pathologist | 6301 Humbert Rd, Godfrey, IL 62035-2163 | 2019-03-15 |
| 1255885414 | Beverly Farm Foundation | Day Training, Developmentally Disabled Services | 6301 Humbert Rd, Godfrey, IL 62035-2163 | 2016-08-05 |
| 1659792315 | Beverly Farm Living Options | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6301 Humbert Rd, Godfrey, IL 62035-2163 | 2013-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548775109 | Bethany E Huelskoetter | Nurse Practitioner | 6702 Godfrey Road, Godfrey, IL 62035 | 2017-12-05 |
| 1720448806 | Sarah Gieszelmann | Nurse Practitioner | 5520 Godfrey Rd Ste B, Godfrey, IL 62035 | 2016-03-02 |
| 1629457536 | Callie Ann Feldman | Occupational Therapy Assistant | 1373 D'adrian Professional Park, Godfrey, IL 62035 | 2015-05-26 |
| 1962767038 | Win U Care for Health | Dietetic Technician, Registered | 321 Big Arch Rd., Godfrey, IL 62035 | 2012-07-05 |
| 1790049831 | Julia Lynn Phillips | Dietetic Technician, Registered | 321 Big Arch Rd, Godfrey, IL 62035 | 2012-07-03 |
| 1578729810 | Home and Environments for Living and Programs | Intermediate Care Facility, Mentally Retarded | 110 N Alby Court, Godfrey, IL 62035 | 2008-08-06 |
| 1497960777 | Joanne T Schulmeister | Dentist | 1203 West Delmar, Godfrey, IL 62035 | 2007-05-11 |
| 1760522965 | Lori Behrens | Social Worker | 5090 Humbert Road, Godfrey, IL 62035 | 2007-02-07 |
| 1699868257 | Beverly Enterprises - Illinois, Inc. | Skilled Nursing Facility | 1623 W. Delmar, #29, Godfrey, IL 62035 | 2006-10-02 |
| 1326147802 | Kymberly Barnard | Speech-Language Pathologist | 6501 Timber Ridge Ln, Godfrey, IL 62035 | 2006-09-21 |
| Find all providers in zip 62035 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578729810 | Home and Environments for Living and Programs | Intermediate Care Facility, Mentally Retarded | 110 N Alby Court, Godfrey, IL 62035 | 2008-08-06 |
| 1376618082 | Beverly Farm Foundation | Intermediate Care Facility, Mentally Retarded | 212 Bachman Ln, Godfrey, IL 62035-2122 | 2006-11-21 |
| 1093880700 | Beverly Farm Foundation | Intermediate Care Facility, Mentally Retarded | 224 Bachman Ln, Godfrey, IL 62035-2122 | 2006-11-21 |
| 1568537272 | Beverly Farm Foundation | Intermediate Care Facility, Mentally Retarded | 314 Bachman Ln, Godfrey, IL 62035-2123 | 2006-11-21 |
| 1902971617 | Beverly Farm Foundation | Intermediate Care Facility, Mentally Retarded | 320 Bachman Ln, Godfrey, IL 62035-2123 | 2006-11-21 |
| 1710051545 | Beverly Farm Foundation | Intermediate Care Facility, Mentally Retarded | 302 Bachman Ln, Godfrey, IL 62035-2123 | 2006-11-20 |
| 1265506091 | Beverly Farm Foundation | Intermediate Care Facility, Mentally Retarded | 308 Bachman Ln, Godfrey, IL 62035-2123 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871039669 | Mount St Joseph | Intermediate Care Facility, Mentally Retarded | 24955 N Us Highway 12, Lake Zurich, IL 60047-8919 | 2017-01-17 |
| 1447792221 | Shore Community Services, Inc. | Intermediate Care Facility, Mentally Retarded | 8350 Laramie Ave, Skokie, IL 60077-2461 | 2016-11-10 |
| 1770930968 | Community Support Systems | Intermediate Care Facility, Mentally Retarded | 2311 Veterans Drive, Effingham, IL 62401 | 2016-05-18 |
| 1265898266 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 102 S Douglas St, Mc Leansboro, IL 62859-1637 | 2016-01-06 |
| 1164888160 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 1406 W Delaware St, Fairfield, IL 62837-2336 | 2016-01-06 |
| 1376909374 | Tdl Group, Inc | Intermediate Care Facility, Mentally Retarded | 416 Chula Vista Dr, Belleville, IL 62221-3160 | 2016-01-06 |
| 1437515434 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 206 N Washington St, Mc Leansboro, IL 62859-1049 | 2016-01-06 |
| 1790141885 | Tdl Group, Inc | Intermediate Care Facility, Mentally Retarded | 212 Turning Leaf Cir, Belleville, IL 62221-6747 | 2016-01-06 |
| 1790141794 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 867 County Road 2150 E, Fairfield, IL 62837-2824 | 2016-01-06 |
| 1255797254 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 9135 N Spring Garden Ln, Mount Vernon, IL 62864-6624 | 2016-01-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.