BRETHREN HOME (NPI# 1548412976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548412976 |
| Entity Type | Organization |
| Organization Name | BRETHREN HOME |
| Other Organization Name | PINECREST MANOR |
| Practice Address |
414 S Wesley Ave Mount Morris IL 61054-1428 |
| Practice Telephone | 8157344103 |
| Practice Fax Number | 8157347318 |
| Mailing Telephone | 8157344103 |
| Mailing Fax Number | 8157347318 |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2009-01-20 |
| Authorized Official Name | MS. CAROL A DAVIS (CEO/ADMINISTRATOR) |
| Authorized Official Telephone | 8157344103 |
| Authorized Official Credential | MBA NHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 347C00000X | Private Vehicle | Transportation Services |
| Other Name | Type Code |
|---|---|
| PINECREST MANOR | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083609960 | Brethren Home | Skilled Nursing Facility | 414 S Wesley Ave, Mount Morris, IL 61054-1428 | 2005-09-15 |
| 1154663946 | Brethren Home | Clinic/Center | 414 S Wesley Ave, Mount Morris, IL 61054-1428 | 2013-03-20 |
| Street Address |
414 S WESLEY AVE |
| City | MOUNT MORRIS |
| State | IL |
| Zip Code | 61054-1428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083609960 | Brethren Home | Skilled Nursing Facility | 414 S Wesley Ave, Mount Morris, IL 61054-1428 | 2005-09-15 |
| 1447898671 | Kristin Charleston | Physical Therapy Assistant | 414 S Wesley Ave, Mount Morris, IL 61054-1428 | 2019-12-18 |
| 1578010377 | Kristen Gilbert | Occupational Therapy Assistant | 414 S Wesley Ave, Mount Morris, IL 61054-1428 | 2016-09-09 |
| 1952705188 | Whitney Ann Cervantez | Speech-Language Pathologist | 414 S Wesley Ave, Mount Morris, IL 61054-1428 | 2014-10-17 |
| 1154663946 | Brethren Home | Clinic/Center | 414 S Wesley Ave, Mount Morris, IL 61054-1428 | 2013-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366671463 | John H Plescia | Family Medicine | 405 Charles Ave, Ksb Medical Group, Mt. Morris, IL 61054 | 2009-07-09 |
| 1043211485 | Bruce E Denton | Chiropractor | 4167 E. Hitt Street, Mt. Morris, IL 61054 | 2005-08-09 |
| 1215203476 | Biome Inc. | Assisted Living Facility | 3160 Sunset Hl, Mount Morris, IL 61054-1000 | 2012-03-31 |
| 1215068325 | Catherine M Wells | Physical Therapy Assistant | 102 N Seminary Ave, Mount Morris, IL 61054-1116 | 2007-03-08 |
| 1285878033 | Aspiring Health, Ltd. | Chiropractor | 315 E Hitt St, Unit 2, Mount Morris, IL 61054-1209 | 2009-04-23 |
| 1730349366 | Mary Saritha Raj | Occupational Therapist | 102 S Mulberry Ave, Mount Morris, IL 61054-1365 | 2008-06-17 |
| 1093850489 | Mt Morris Fire Protection District | Ambulance | 15 E Center St, Mt Morris, IL 61054-1460 | 2007-02-21 |
| 1215057898 | Mt Morris Fire Protection District | Ambulance | 15 E Center St, Mount Morris, IL 61054-1460 | 2007-03-29 |
| 1457619009 | Brittany Ann Nelson | Social Worker | 408 Bruce Ln, Mount Morris, IL 61054-1630 | 2012-05-01 |
| 1538288022 | Kenneth William Kaufman | Dentist | 105 E Lincoln Street, Mt Morris, IL 61054-1640 | 2007-03-28 |
| Find all providers in zip 61054 | ||||
| Taxonomy Code | 347C00000X |
| Grouping | Transportation Services |
| Classification | Private Vehicle |
| An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184223703 | Jimmy D Hill | Private Vehicle | 300 W Bond Ave Apt 11, Patoka, IL 62875-1044 | 2020-10-23 |
| 1033716675 | Tuwana Hunter | Private Vehicle | 512 N Jackson St, Waukegan, IL 60085-3848 | 2020-10-07 |
| 1407462336 | Connect Care Trans LLC | Private Vehicle | 2454 W Peterson Ave, Chicago, IL 60659-4113 | 2020-09-16 |
| 1437769577 | Steven Walls | Private Vehicle | 12 Chatham Cir, Kankakee, IL 60901-5802 | 2020-08-04 |
| 1275166514 | Ira Lee Williams | Private Vehicle | 9801 S Karlov Ave Apt 203, Oak Lawn, IL 60453-3443 | 2020-02-14 |
| 1033740477 | Karriage Incorporated | Private Vehicle | 8314 W 95th St, Hickory Hills, IL 60457-1951 | 2020-02-03 |
| 1275179178 | William Smith Iv | Private Vehicle | 2535 S Twin Bridge Rd, Decatur, IL 62521-9604 | 2019-11-26 |
| 1972147627 | Td Reliable Transport LLC | Private Vehicle | 1462 Legacy Dr Unit 4, Dekalb, IL 60115-2078 | 2019-11-05 |
| 1225670151 | Margaret Sharice Ward | Private Vehicle | 1995 W Meadowview Dr, Round Lake, IL 60073-9793 | 2019-10-11 |
| 1427699081 | Tb Transportation Enterprise Inc | Private Vehicle | 4114 W Gladys Ave, Chicago, IL 60624-3284 | 2019-10-04 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT MORRIS |
| Zip Code | 61054 |
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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.