GOLDIE B. FLOBERG CENTER (NPI# 1639559495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639559495 |
| Entity Type | Organization |
| Organization Name | GOLDIE B. FLOBERG CENTER |
| Practice Address |
58 W Rockton Rd Rockton IL 61072-1631 |
| Practice Telephone | 8156248431 |
| Mailing Telephone | 8156248431 |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-06-05 |
| Authorized Official Name | JOHN PINGO (CEO/BCBA) |
| Authorized Official Telephone | 8156248431 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629112966 | Goldie B. Floberg Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 58 W Rockton Rd, Rockton, IL 61072-1631 | 2007-02-19 |
| Street Address |
58 W ROCKTON RD |
| City | ROCKTON |
| State | IL |
| Zip Code | 61072-1631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629112966 | Goldie B. Floberg Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 58 W Rockton Rd, Rockton, IL 61072-1631 | 2007-02-19 |
| 1720578503 | Tiffany Kragenbrink | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 58 W Rockton Rd, Rockton, IL 61072-1699 | 2018-05-16 |
| 1083064687 | Elizabeth Lutmer | Specialist | 58 W Rockton Rd, Rockton, IL 61072-1631 | 2016-06-15 |
| 1871943472 | Thomas Wood | Specialist | 58 W Rockton Rd, Rockton, IL 61072-1631 | 2016-06-15 |
| 1154701217 | Goldie Floberg Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 58 W Rockton Rd, Rockton, IL 61072-1631 | 2015-06-04 |
| 1356721526 | Goldie B. Floberg Center for Children | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 58 W Rockton Rd, Rockton, IL 61072-1631 | 2015-06-03 |
| 1578992475 | Zachery Fiduccia | Behavioral Analyst | 58 W Rockton Rd, Rockton, IL 61072-1631 | 2013-11-01 |
| 1942454681 | John Pingo | Behavioral Analyst | 58 W Rockton Rd, Rockton, IL 61072-1631 | 2008-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750822649 | Brianna Helene Jensen | Specialist/Technologist | 11746 Deacon Dr, Rockton, IL 61072 | 2017-03-13 |
| 1891085767 | James Adrian Fogarty | Psychologist | 122 S. Prairie St. Suite A, Rockton, IL 61072 | 2011-04-13 |
| 1871623447 | Wal-mart Stores, Inc Dba Wal-mart | Technician/Technologist | 4781 E. Rockton Rd., Rockton, IL 61072 | 2007-03-06 |
| 1215070487 | Shelly L Patchett | Social Worker | 1107 N Blackhawk Blvd, Suite 8, Rockton, IL 61072-1500 | 2007-02-15 |
| 1245301472 | Brandi M Lander | Counselor | 1107 N. Blackhawk Blvd, Suite 8, Rockton, IL 61072-1500 | 2006-11-10 |
| 1033551320 | Stateline Counseling Services LLC | Social Worker | 1107 N Blackhawk Blvd, Suite 8, Rockton, IL 61072-1500 | 2013-07-26 |
| 1811987886 | Vasil Nika | Family Medicine | 1511 N Blackhawk Blvd, University Primary Care Clinic @ Rockton, Rockton, IL 61072-1513 | 2005-10-21 |
| 1245747971 | Nicole Atanasoff | Nurse Practitioner | 1511 N Blackhawk Blvd, Rockton, IL 61072-1513 | 2018-01-03 |
| 1588964712 | Carole J Eatock | Nurse Practitioner | 1511 N Blackhawk Blvd, Rockton, IL 61072-1513 | 2010-10-21 |
| 1952348831 | Board of Trustees of The University of Illinois | Family Medicine | 1511 N Blackhawk Blvd, Rockton, IL 61072-1513 | 2006-06-01 |
| Find all providers in zip 61072 | ||||
| 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 |
|---|---|---|---|---|
| 1720578503 | Tiffany Kragenbrink | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 58 W Rockton Rd, Rockton, IL 61072-1699 | 2018-05-16 |
| 1154701217 | Goldie Floberg Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 58 W Rockton Rd, Rockton, IL 61072-1631 | 2015-06-04 |
| 1356721526 | Goldie B. Floberg Center for Children | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 58 W Rockton Rd, Rockton, IL 61072-1631 | 2015-06-03 |
| 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.