BETHESDA LUTHERAN HOMES & SERVICES INC (NPI# 1417102070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417102070 |
| Entity Type | Organization |
| Organization Name | BETHESDA LUTHERAN HOMES & SERVICES INC |
| Practice Address |
1205 S Spencer St Aurora IL 60505-5735 |
| Mailing Address |
600 Hoffmann Dr Watertown WI 53094-6223 |
| Practice Telephone | 6308208597 |
| Mailing Telephone | 9202613050 |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2008-11-24 |
| Authorized Official Name | MR. JEFFREY A KACZMARSKI (CLAO) |
| Authorized Official Telephone | 9202064406 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548415342 | Bethesda Lutheran Homes & Services Inc | Intermediate Care Facility, Mentally Retarded | 14907 S Eastern Ave, Plainfield, IL 60544-3151 | 2008-11-20 |
| 1396990198 | Bethesda Lutheran Homes & Services Inc | Intermediate Care Facility, Mentally Retarded | 1480 Reckinger Rd, Aurora, IL 60505-1624 | 2008-11-20 |
| Street Address |
1205 S SPENCER ST |
| City | AURORA |
| State | IL |
| Zip Code | 60505-5735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538705330 | Johnathan Dunn | Counselor | 140 S. Lincoln Ave., Aurora, IL 60505 | 2019-11-27 |
| 1720638224 | Latanya Rush | Technician | 1664 Briarheath Dr, Aurora, IL 60505 | 2019-09-17 |
| 1285282103 | Susan Burroway | Technician | 815 Pearl St., Aurora, IL 60505 | 2019-09-04 |
| 1629624499 | Jean Amanda Nalwoga | Counselor | 1305 E New Indian Trail, Aurora, IL 60505 | 2019-08-16 |
| 1760987515 | Eric Raul Simental | Preventive Medicine | 1014 Claim St, Aurora, IL 60505 | 2018-03-26 |
| 1518408426 | Oluwole Michael Olubajo | Nurse's Aide | 716 Mountain Street, Apt#2e, Aurora, IL 60505 | 2017-03-10 |
| 1881017960 | Anthony Maranto | Counselor | 1305 E. Indian Trail Ct., Aurora, IL 60505 | 2014-01-27 |
| 1891121141 | Smithhealthcare Properties | Assisted Living Facility | 105 E Galena Bvld #3, Aurora, IL 60505 | 2013-09-18 |
| 1003253865 | Laura A Romero | Speech-Language Pathologist | 1770 Daisy St, Aurora, IL 60505 | 2013-06-03 |
| 1972878197 | Donald C. Kellner Dds-aurora PC | Dentist | 143 South Lincoln Ave, Suite A, Aurora, IL 60505 | 2012-03-21 |
| Find all providers in zip 60505 | ||||
| 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 |
|---|---|---|---|---|
| 1619129715 | Association for Individual Development | Intermediate Care Facility, Mentally Retarded | 421 N Constitution Dr, Aurora, IL 60506-3209 | 2008-10-21 |
| 1982723300 | Voca In, LLC | Intermediate Care Facility, Mentally Retarded | 207 Hanover Ave, Aurora, IN 47001-1151 | 2007-03-28 |
| 1609994326 | Voca of Indiana LLC | Intermediate Care Facility, Mentally Retarded | 511 W Conwell St, Aurora, IN 47001-1137 | 2007-03-27 |
| 1396990198 | Bethesda Lutheran Homes & Services Inc | Intermediate Care Facility, Mentally Retarded | 1480 Reckinger Rd, Aurora, IL 60505-1624 | 2008-11-20 |
| 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 |
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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.