MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS (NPI# 1225361769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225361769 |
Entity Type | Organization |
Organization Name | MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS |
Other Organization Name | MEMORIAL BEHAVIORAL HEALTH - SPRINGFIELD RESIDENTIAL CENTER (BLDG A) |
Practice Address |
200 W Lake Dr Building A Springfield IL 62703-4956 |
Mailing Address |
710 N 8th St Springfield IL 62702-6324 |
Practice Telephone | 2175299775 |
Practice Fax Number | 2175299803 |
Mailing Telephone | 2175251064 |
Mailing Fax Number | 2175251651 |
Enumeration Date | 2009-09-16 |
Last Update Date | 2016-03-17 |
Authorized Official Name | ROBYN L LUKE (ADMINISTRATOR) |
Authorized Official Telephone | 2175251064 |
Is Organization Subpart | Y |
Parent Organization Name | MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Memorial Behavioral Health - Springfield Residential Center (Bldg A) | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730554692 | Mental Health Centers of Central Illinois | Day Training, Developmentally Disabled Services | 760 S Postville Dr, Lincoln, IL 62656-2237 | 2015-12-03 |
1558910794 | Mental Health Centers of Central Illinois | Clinic/Center | 303 E Bidwell St, Taylorville, IL 62568-1363 | 2019-09-10 |
1013401322 | Mental Health Centers of Central Illinois | Clinic/Center | 340 W State St, Jacksonville, IL 62650-2061 | 2018-06-20 |
1295160323 | Mental Health Centers of Central Illinois | Clinic/Center | 515 N College St, Lincoln, IL 62656-1401 | 2013-09-09 |
1750614798 | Mental Health Centers of Central Illinois | Counselor | 901 N 1st St, Suite 225, Springfield, IL 62702-3759 | 2009-09-09 |
1023263043 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building C, Springfield, IL 62703-4956 | 2008-11-18 |
1932354958 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building D, Springfield, IL 62703-4956 | 2008-11-18 |
1841445863 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building E, Springfield, IL 62703-4956 | 2008-11-18 |
1659525863 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Buidling B, Springfield, IL 62703-4956 | 2008-11-14 |
1457505125 | Mental Health Centers of Central Illinois | Clinic/Center | 5220 S 6th Street Rd, Suite 2400, Springfield, IL 62703-5735 | 2008-11-07 |
Street Address |
200 W LAKE DR BUILDING A |
City | SPRINGFIELD |
State | IL |
Zip Code | 62703-4956 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114987690 | James L. Wilkerson | Counselor | 200 W Lake Dr, Springfield, IL 62703-4956 | 2006-03-27 |
1023263043 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building C, Springfield, IL 62703-4956 | 2008-11-18 |
1104071125 | West Lake Residential - Building 220 | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building 220, Springfield, IL 62703-4956 | 2008-11-18 |
1932354958 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building D, Springfield, IL 62703-4956 | 2008-11-18 |
1841445863 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building E, Springfield, IL 62703-4956 | 2008-11-18 |
1659525863 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Buidling B, Springfield, IL 62703-4956 | 2008-11-14 |
1346428786 | Cynthia S. Mester | Counselor | 200 W Lake Dr, Springfield, IL 62703-4956 | 2008-02-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790260917 | Jessica Lynne Zeeck | Behavior Technician | 5220 6th Street Frontage Road, E Suite 1700, Springfield, IL 62703 | 2018-10-03 |
1215415799 | Bree Schmulbach | Nurse Practitioner | Bsb Room 20, Springfield, IL 62703 | 2018-08-06 |
1144712100 | Fresenius Medical Care Springfield East, LLC | Clinic/Center | 140 S. Martin Luther King Jr. Drive, Springfield, IL 62703 | 2018-06-05 |
1558889170 | Ji Woung Choi | Dentist | 687 E Linton Ave., Springfield, IL 62703 | 2017-09-04 |
1477006161 | Encompass Home Health of The Midwest,llc | Home Health | 2970 Baker Dr, Springfield, IL 62703 | 2016-07-28 |
1851706824 | Terah Louise Holland | Obstetrics & Gynecology | 1100 E Lincolnshire Blvd Ste 200, Springfield, IL 62703 | 2014-06-27 |
1578993101 | Corey Moore | Behavioral Analyst | 5520 South 6th Street Road, Suite 1700, Springfield, IL 62703 | 2013-11-18 |
1134463052 | The Center for Youth and Family Solutions Inc. | Voluntary or Charitable | 614 North Sixth Street, Springfield, IL 62703 | 2012-11-15 |
1447519111 | Tenshi Furumi | Specialist/Technologist | One University Plaza, Univ. of Illinois-springfield, Ms Rec 2004, Springfield, IL 62703 | 2012-05-15 |
1447558390 | Shalini Mulkanoor | Family Medicine | 1100 E. Lincolnshire Blvd., Suite 200, Springfield, IL 62703 | 2011-03-02 |
Find all providers in zip 62703 |
Taxonomy Code | 261QM0801X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Mental Health (Including Community Mental Health Center) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710597406 | Bridge of Changes | Clinic/Center | 215 Berkshire Ave, Springfield, MA 01109-1638 | 2020-08-06 |
1861024754 | Chrysalis Wellness LLC | Clinic/Center | 3863 S Campbell Ave Ste A, Springfield, MO 65807-5339 | 2020-02-07 |
1275178451 | Awaken360, Inc. | Clinic/Center | 829 W Atlantic St, Springfield, MO 65803-1517 | 2019-11-12 |
1235693623 | Eyes On Therapy | Clinic/Center | 1207 N Plum St Ste A, Springfield, OH 45504-1865 | 2019-01-30 |
1912474586 | Hope Source Counseling | Clinic/Center | 1736 E Sunshine St Ste 813, Springfield, MO 65804-1334 | 2018-10-31 |
1760964910 | Wellness for The Culture LLC | Clinic/Center | 44 Superior Ave, Springfield, MA 01151-1836 | 2018-09-04 |
1003315177 | Counter Balance | Clinic/Center | 56 Main St Ste 212, Springfield, VT 05156-2945 | 2018-02-05 |
1558805754 | Bhg Xliii, LLC | Clinic/Center | 2551 W Kearney St, Springfield, MO 65803 | 2016-12-07 |
1538575295 | Sunrise Behavioral Health Clinic, LLC | Clinic/Center | 95 Frank B. Murray Street, Springfield, MA 01103 | 2014-07-02 |
1326296856 | Gateway Foundation, Inc. | Clinic/Center | 2200 Lake Victoria Dr, Springfield, IL 62703-5596 | 2008-09-09 |
Find all providers in SPRINGFIELD |
City | SPRINGFIELD |
Zip Code | 62703 |
Please comment or provide details below to improve the information on MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS.
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.