BEVERLY FARM LIVING OPTIONS (NPI# 1659792315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659792315 |
| Entity Type | Organization |
| Organization Name | BEVERLY FARM LIVING OPTIONS |
| Practice Address |
6301 Humbert Rd Godfrey IL 62035-2163 |
| Practice Telephone | 6184660367 |
| Practice Fax Number | 6184663652 |
| Mailing Telephone | 6184660367 |
| Mailing Fax Number | 6184663652 |
| Enumeration Date | 2013-12-26 |
| Last Update Date | 2013-12-26 |
| Authorized Official Name | MS. MARTHA A. WARFORD (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6184660367 |
| 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 | 201300002M | IL | Residential Treatment Facilities |
| Street Address |
6301 HUMBERT RD |
| City | GODFREY |
| State | IL |
| Zip Code | 62035-2163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174696157 | Beverly Farm Foundation | Intermediate Care Facility, Mentally Retarded | 6301 Humbert Rd, Godfrey, IL 62035-2163 | 2006-11-16 |
| 1699234062 | Allie E Thyer | Speech-Language Pathologist | 6301 Humbert Rd, Godfrey, IL 62035-2163 | 2019-03-15 |
| 1255885414 | Beverly Farm Foundation | Day Training, Developmentally Disabled Services | 6301 Humbert Rd, Godfrey, IL 62035-2163 | 2016-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548775109 | Bethany E Huelskoetter | Nurse Practitioner | 6702 Godfrey Road, Godfrey, IL 62035 | 2017-12-05 |
| 1720448806 | Sarah Gieszelmann | Nurse Practitioner | 5520 Godfrey Rd Ste B, Godfrey, IL 62035 | 2016-03-02 |
| 1629457536 | Callie Ann Feldman | Occupational Therapy Assistant | 1373 D'adrian Professional Park, Godfrey, IL 62035 | 2015-05-26 |
| 1962767038 | Win U Care for Health | Dietetic Technician, Registered | 321 Big Arch Rd., Godfrey, IL 62035 | 2012-07-05 |
| 1790049831 | Julia Lynn Phillips | Dietetic Technician, Registered | 321 Big Arch Rd, Godfrey, IL 62035 | 2012-07-03 |
| 1578729810 | Home and Environments for Living and Programs | Intermediate Care Facility, Mentally Retarded | 110 N Alby Court, Godfrey, IL 62035 | 2008-08-06 |
| 1497960777 | Joanne T Schulmeister | Dentist | 1203 West Delmar, Godfrey, IL 62035 | 2007-05-11 |
| 1760522965 | Lori Behrens | Social Worker | 5090 Humbert Road, Godfrey, IL 62035 | 2007-02-07 |
| 1699868257 | Beverly Enterprises - Illinois, Inc. | Skilled Nursing Facility | 1623 W. Delmar, #29, Godfrey, IL 62035 | 2006-10-02 |
| 1326147802 | Kymberly Barnard | Speech-Language Pathologist | 6501 Timber Ridge Ln, Godfrey, IL 62035 | 2006-09-21 |
| Find all providers in zip 62035 | ||||
| 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 |
|---|---|---|---|---|
| 1962914770 | Residential Options, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5125 Dixon Dr, Godfrey, IL 62035-1419 | 2017-11-02 |
| 1598121253 | Residential Options, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5007 Michael Dr, Godfrey, IL 62035-1371 | 2016-01-12 |
| 1770702763 | Residential Options, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4710 Pierce Ln, Godfrey, IL 62035-4151 | 2007-04-25 |
| 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.