IMBODEN CREEK LIVING CENTERS (NPI# 1427405075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427405075 |
| Entity Type | Organization |
| Organization Name | IMBODEN CREEK LIVING CENTERS |
| Practice Address |
180 W Imboden Dr Decatur IL 62521-5238 |
| Practice Telephone | 2174227150 |
| Practice Fax Number | 2174229418 |
| Mailing Telephone | 2174227150 |
| Mailing Fax Number | 2174229418 |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-05-24 |
| Authorized Official Name | MRS. BEVERLEY KAY BAITY (MEDICARE BILLER) |
| Authorized Official Telephone | 2174227150 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
Suppliers |
| Street Address |
180 W IMBODEN DR |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-5238 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790782308 | Living Centers Inc | Skilled Nursing Facility | 180 W Imboden Dr, Decatur, IL 62521-5238 | 2005-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 332BX2000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Oxygen Equipment & Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932204856 | Specialized Medical Devices Inc | Durable Medical Equipment & Medical Supplies | 2418 Danville Rd Sw, Ste D, Decatur, AL 35603-4281 | 2006-09-14 |
| 1467868174 | P & R Home Iv Service, Inc. | Durable Medical Equipment & Medical Supplies | 1100 Mercer Ave, Suite A122, Decatur, IN 46733-2303 | 2014-07-02 |
| 1346670148 | Complete Choice Inc | Durable Medical Equipment & Medical Supplies | 2828 Highway 31 S, Suite 130, Decatur, AL 35603-1510 | 2013-11-15 |
| 1609108729 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 2217 Spring Ave Sw, Decatur, AL 35601-5719 | 2010-02-01 |
| 1528219938 | Fair Havens Christian Home, Inc. | Durable Medical Equipment & Medical Supplies | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2008-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699026 | First Choice Medical Equipment, Inc | Durable Medical Equipment & Medical Supplies | 65 S 65th St Ste 10, Belleville, IL 62223-2946 | 2020-11-04 |
| 1619596624 | Gz Service Inc | Durable Medical Equipment & Medical Supplies | 576 Jennifer Cir, Mundelein, IL 60060-4110 | 2020-04-09 |
| 1528690526 | Nationwide Medical, Inc. | Durable Medical Equipment & Medical Supplies | 415 W Golf Rd Ste 48, Arlington Heights, IL 60005-3923 | 2020-02-07 |
| 1477024347 | Karma7 Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 1840 Industrial Dr Ste 160, Libertyville, IL 60048-9400 | 2018-12-17 |
| 1700354354 | True Respiratory Care & Medical Management LLC | Durable Medical Equipment & Medical Supplies | 11415 183rd Pl Ste B, Orland Park, IL 60467-5011 | 2018-11-12 |
| 1467951699 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 903 N Maple St, Effingham, IL 62401 | 2018-02-02 |
| 1215436449 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 300 Coles Centre Pkwy, Mattoon, IL 61938 | 2018-02-02 |
| 1669992665 | Easy Oxygen Inc. | Durable Medical Equipment & Medical Supplies | 1862 E Belvidere Road #125, Grayslake, IL 60030 | 2017-06-21 |
| 1487103560 | The Elms | Durable Medical Equipment & Medical Supplies | 1212 Madelyn Ave, Macomb, IL 61455-3324 | 2016-09-29 |
| 1457807257 | Genventures Inc | Durable Medical Equipment & Medical Supplies | 101 S. College Avenue, Aledo, IL 61231-1630 | 2016-08-31 |
| 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.