HOMESTEAD HOUSE (NPI# 1881884187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881884187 |
| Entity Type | Organization |
| Organization Name | HOMESTEAD HOUSE |
| Practice Address |
905 North Jefferson West Frankfort IL 62896 |
| Mailing Address |
1120 North Division Street Carterville IL 62918 |
| Practice Telephone | 6189322725 |
| Practice Fax Number | 6189322660 |
| Mailing Telephone | 6189858351 |
| Mailing Fax Number | 6189858817 |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MR. WILLIAM JAMES MATTINGLY (PARTNER ADMINISTRATOR) |
| Authorized Official Telephone | 6189858351 |
| 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 | IL | Residential Treatment Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | HOMESTEAD HOUSE LLC | 735 Browning Ave Se #120, Salem, OR 97302 |
| Colorado Business Entities | Homestead House LLC | 41 Lime Park Dr, Eagle, CO 81631 |
| Oregon Corporations, Companies and Business Names | HOMESTEAD HOUSE PDX | 8012 Se 13th Avenue, Portland, OR 97202 |
| Colorado Business Entities | HOMESTEAD HOUSE, INC. | 10383 Yates Court, Westminster, CO 80031 |
| Oklahoma Business Registrations | HOMESTEAD HOUSE, INC. | 9410 Wadsworth Pkwy,po Box 499, Broomfield, CO 80020 |
| Colorado Business Entities | Homestead Houseboat LLC | 15437 Mountain View Circle, Broomfield, CO 80023 |
| Street Address |
905 NORTH JEFFERSON |
| City | WEST FRANKFORT |
| State | IL |
| Zip Code | 62896 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417468406 | Desrie Dawn Farley | Psychologist | 508 East Main, West Frankfort, IL 62896 | 2017-10-17 |
| 1205346657 | Erin Hutchinson | Speech-Language Pathologist | 1401 W Sixth St, West Frankfort, IL 62896 | 2017-10-11 |
| 1326499740 | Casey Huff | Counselor | 202 South Bentley St, Marion, IL 62896 | 2016-06-27 |
| 1629321922 | Sage Psychiatry LLC | Psychiatry & Neurology | 410 W St Louis Street, West Frankfort, IL 62896 | 2012-10-24 |
| 1497907737 | Angela H Henson | Physician Assistant | 310 West St. Louis Street, West Frankfort, IL 62896 | 2008-10-17 |
| 1528266608 | Christopher Greater Area Rural Health Planning Corp | Family Medicine | 502 West St Louis Street, West Frankfort Community Health Center, West Frankfort, IL 62896 | 2007-07-10 |
| 1437212016 | National Assistance Bureau, Inc. | Skilled Nursing Facility | Westside Care Center, 601 North Columbia St, West Frankfort, IL 62896 | 2006-12-18 |
| 1922176171 | Sebastian John Pagano | Dentist | 208 North Ida, West Frankfort, IL 62896 | 2006-12-04 |
| 1023123346 | Logan Primary Care Service Corp. | Clinic/Center | 502 W St Louis, West Frankfort, IL 62896 | 2006-08-19 |
| 1326152356 | Christopher S Shadowens | Physician Assistant | 502 St Louis Street, West Frankfort, IL 62896 | 2006-08-18 |
| Find all providers in zip 62896 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
| City | WEST FRANKFORT |
| Zip Code | 62896 |
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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.