ASSOCIATION FOR THE DEVELOPMENTALLY DISABLED OF WOODFORD COUNTY (NPI# 1225405137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225405137 |
| Entity Type | Organization |
| Organization Name | ASSOCIATION FOR THE DEVELOPMENTALLY DISABLED OF WOODFORD COUNTY |
| Practice Address |
200 Moody St Eureka IL 61530-1705 |
| Practice Telephone | 3094673015 |
| Practice Fax Number | 3094675206 |
| Mailing Telephone | 3094673015 |
| Mailing Fax Number | 3094675206 |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2015-08-26 |
| Authorized Official Name | MR. KEITH MCARDLE (PRESIDENT/CEO) |
| Authorized Official Telephone | 3094673015 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | 199600006S | IL | Agencies |
| N | 251C00000X | Day Training, Developmentally Disabled Services | 199600006S | IL | Agencies |
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 199600006S | IL | Residential Treatment Facilities |
| Street Address |
200 MOODY ST |
| City | EUREKA |
| State | IL |
| Zip Code | 61530-1705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134464316 | Tazwood Mental Health Center, Inc. | Community/Behavioral Health | 101 S. Major Street, Eureka, IL 61530 | 2012-11-29 |
| 1508009234 | Woodford County | Substance Abuse Rehabilitation Facility | 105 E Court St, Eureka, IL 61530 | 2009-04-10 |
| 1609889914 | Apostolic Christian Home of Eureka | Skilled Nursing Facility | 610 W. Cruger St., Eureka, IL 61530 | 2006-08-15 |
| 1326003344 | Eric John Larson | Counselor | 109 E Eureka, Eureka, IL 61530 | 2006-04-20 |
| 1467789511 | Julie Tuttle | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61530 | 2009-11-11 |
| 1720073414 | Maple Lawn Health Center | Skilled Nursing Facility | 700 N Main St, Eureka, IL 61530-1085 | 2005-09-19 |
| 1992158356 | Kendra Mickelson | Skilled Nursing Facility | 700 N Main St, Eureka, IL 61530-1085 | 2016-07-20 |
| 1720439110 | Loft Rehabilitation and Nursing LLC | Skilled Nursing Facility | 700 N Main St, Eureka, IL 61530-1085 | 2016-06-27 |
| 1841470374 | Maple Lawn Homes Inc. | Clinic/Center | 700 N Main St, Eureka, IL 61530-1085 | 2007-11-13 |
| 1093818767 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 501 W Center St, Eureka, IL 61530-1111 | 2006-09-07 |
| Find all providers in zip 61530 | ||||
| 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 |
|---|---|---|---|---|
| 1700390762 | Brennan's Home L.L.C. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 54 The Legends Pkwy Ste 155, Eureka, MO 63025-3803 | 2017-11-28 |
| 1477697209 | Powderly and Associates, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 346 Lewis Bluff Cir, Eureka, MO 63025-1638 | 2007-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275131419 | Foatex Health Cilacare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 823 163rd St, Calumet City, IL 60409-5915 | 2020-10-10 |
| 1053949404 | A Great Place To Stay LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 35580 N Knowles Rd, Lake Villa, IL 60046-9026 | 2020-03-31 |
| 1255966602 | Infinicare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1939 Waukegan Rd Ste 300, Glenview, IL 60025-1758 | 2020-03-05 |
| 1023643772 | Supporting Community Independence | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1 Polo Grounds Ct, Bethalto, IL 62010-2623 | 2020-03-03 |
| 1770116287 | Universal Homes LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12101 S La Salle St, Chicago, IL 60628-6618 | 2020-02-13 |
| 1760014625 | Tomeka R Morgan | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11543 S Ashland Ave, Chicago, IL 60643-5001 | 2020-02-10 |
| 1487292660 | Shalom Home Health Ltd | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8147 Seminole Ct, Orland Park, IL 60462-4919 | 2019-12-18 |
| 1447894613 | Compassionate Living Home Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2625 Butterfield Rd Ste 314e, Oak Brook, IL 60523-1234 | 2019-10-31 |
| 1417599945 | Miracle Comprehensive Serivces | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4440 Lincoln Hwy Ste 205, Matteson, IL 60443-3803 | 2019-10-16 |
| 1609435072 | Bliss Haven, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1304 Durham St, Johnston City, IL 62951-2043 | 2019-06-10 |
| 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.