WILLOWGLEN ACADEMY-ILLINOIS INC (NPI# 1215441050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215441050 |
| Entity Type | Organization |
| Organization Name | WILLOWGLEN ACADEMY-ILLINOIS INC |
| Practice Address |
701 W Lamm Rd Freeport IL 61032-9630 |
| Practice Telephone | 8152336162 |
| Mailing Telephone | 8152336162 |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2017-11-30 |
| Authorized Official Name | ELIZABETH A KINARD (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8152625254 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
701 W LAMM RD |
| City | FREEPORT |
| State | IL |
| Zip Code | 61032-9630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285838458 | Judy Ann Strey | Speech-Language Pathologist | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2007-06-12 |
| 1225544901 | Gloria Ann Ennenbach | Registered Nurse | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2017-12-18 |
| 1881100600 | Willowglen Academy Illinois | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2017-12-15 |
| 1548703887 | Ervin Wainwright | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-18 |
| 1932641164 | Erik Walton | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-04 |
| 1558803783 | Antoinette Harvey | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-04 |
| 1740732908 | Martrice Collier | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-03 |
| 1184176448 | Roland Emeka Aguocha | Social Worker | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-02 |
| 1194277541 | Carrie Snow | Counselor | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-11-02 |
| 1710439435 | Willowglen Academy | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2016-10-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517713 | Saad Awan | Pharmacist | 2545 Illinois 26 S, Freeport, IL 61032 | 2020-10-30 |
| 1891354460 | Freeport Chiropractic LLC | Chiropractor | 2 W Stephenson St, Freeport, IL 61032 | 2019-06-07 |
| 1487168373 | Lindsey Rae Harris-baker | Speech-Language Pathologist | 1802 W Laurel St, Freeport, IL 61032 | 2017-11-30 |
| 1861871246 | Pearl Pavilion LLC | Skilled Nursing Facility | 910 Kiwanis Drive, Freeport, IL 61032 | 2015-05-19 |
| 1245584598 | Mary E Brown | Massage Therapist | 815 W. Pleasant Street, Freeport, IL 61032 | 2012-11-07 |
| 1700135803 | April Braband | Specialist | 421 Exchange, Freeport, IL 61032 | 2012-09-05 |
| 1518198662 | Quad City Prosthetic Inc | Prosthetic/Orthotic Supplier | 1013 W Loras Dr, Suite A, Freeport, IL 61032 | 2009-08-06 |
| 1447486501 | Gary Alan Besley | Dentist | 1450 S. West Ave., Freeport, IL 61032 | 2009-06-03 |
| 1023244290 | Allies In Health Sc | Chiropractor | 418 W Meadows Dr., Freeport, IL 61032 | 2009-06-02 |
| 1912146614 | Kayla Nicole Rodebaugh | Specialist/Technologist | 1010 Fairway Drive, Freeport, IL 61032 | 2009-02-19 |
| Find all providers in zip 61032 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598097016 | Willowglen Academy-il, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 564 N Greenfield Dr, Freeport, IL 61032-2943 | 2010-02-09 |
| 1093919797 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 239 Winnefred St., Freeport, IL 61032 | 2007-06-14 |
| 1700080629 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 Arcade Ct, Freeport, IL 61032-6040 | 2007-06-13 |
| 1982808895 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 833 S 16th Ave, Freeport, IL 61032-5921 | 2007-06-13 |
| 1386848299 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3111 W Kunkle Blvd, Freeport, IL 61032-6922 | 2007-06-13 |
| 1891999710 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 227 E Washington St, Freeport, IL 61032-5162 | 2007-06-13 |
| 1164626305 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 321 N Whistler Ave, Freeport, IL 61032-3958 | 2007-06-12 |
| 1255535498 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 730 N Brewster Ave, Freeport, IL 61032-3113 | 2007-06-12 |
| 1598969073 | Willowglen Academy-il | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1653 De Boer Ln, Freeport, IL 61032-5900 | 2007-06-11 |
| 1881100600 | Willowglen Academy Illinois | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 701 W Lamm Rd, Freeport, IL 61032-9630 | 2017-12-15 |
| Find all providers in FREEPORT | ||||
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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.