VILLAGE INN COBDEN, INC (NPI# 1922277037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922277037 |
| Entity Type | Organization |
| Organization Name | VILLAGE INN COBDEN, INC |
| Practice Address |
114 Ash Street Cobden IL 62920-0457 |
| Mailing Address |
Po Box 457 Cobden IL 62920-0457 |
| Practice Telephone | 6188934222 |
| Practice Fax Number | 6188335295 |
| Mailing Telephone | 6188934222 |
| Mailing Fax Number | 6188335295 |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2016-06-24 |
| Authorized Official Name | MR. MATT CHAMNESS (OWNER/PRESIDENT) |
| Authorized Official Telephone | 6188934222 |
| 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 | 201000004M | IL | Residential Treatment Facilities |
| Street Address |
114 ASH STREET |
| City | COBDEN |
| State | IL |
| Zip Code | 62920-0457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063930675 | Haley Estes | Social Worker | 413 N. Appleknocker Drive, Cobden, IL 62920 | 2017-09-04 |
| 1508313115 | Dee Dillon | Licensed Practical Nurse | 211 S Appleknocker St, Cobden, IL 62920 | 2016-09-01 |
| 1619165941 | Kristie Ann Russell | Counselor | 3455 Wing Hill Rd, Cobden, IL 62920 | 2007-10-11 |
| 1003873738 | Laura C Mears | Dentist | 103 N Appleknocker, Cobden, IL 62920 | 2006-04-27 |
| 1245551688 | Renee Rose Juarez | Developmental Therapist | 440 Oak St, Cobden, IL 62920-2107 | 2010-06-21 |
| 1700863552 | Jennifer E Mihalopulos | Dentist | 103 N. Appleknocker, Cobden, IL 62920-2117 | 2005-12-22 |
| 1720104938 | Cobden Sch Unit Dist 17 | Clinic/Center | 413 N Appleknocker St, Cobden, IL 62920-2121 | 2007-03-21 |
| 1992218937 | Nancy Ellen Mcnitt | Registered Nurse | 413 N Appleknocker St, Cobden, IL 62920-2121 | 2017-11-13 |
| 1285152256 | Allison Brooke Wills | Speech-Language Pathologist | 413 N Appleknocker St, Cobden, IL 62920-2121 | 2017-08-30 |
| 1497922462 | Cobden Unit School District 17 | Clinic/Center | 413 N Appleknocker St, Cobden, IL 62920-2121 | 2008-05-09 |
| Find all providers in zip 62920 | ||||
| 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 | ||||
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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.