PRESENCE HERITAGE DAY BREAK


Address: 1025 N Washington Ave, Kankakee, IL 60901-2059
Phone: 8159372447

PRESENCE HERITAGE DAY BREAK (NPI# 1962896431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1962896431
Entity Type Organization
Organization Name PRESENCE HERITAGE DAY BREAK
Practice Address 1025 N Washington Ave
Kankakee
IL 60901-2059
Practice Telephone 8159372447
Practice Fax Number 7084785387
Mailing Telephone 8159372447
Mailing Fax Number 7084785387
Enumeration Date 2015-03-23
Last Update Date 2015-03-23
Authorized Official Name MR. MICHAEL GORDON (CFO)
Authorized Official Telephone 7084787911
Is Organization Subpart Y
Parent Organization Name PRESENCE LIFE CONNECTIONS

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QA0600X Clinic/Center
Specialization: Adult Day Care
IL Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
IL ILLINOIS DEPARTMENT OF AGING ADS1002010 01

Office Location

Street Address 1025 N WASHINGTON AVE
City KANKAKEE
State IL
Zip Code 60901-2059

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Taxonomy Information

Taxonomy Code 261QA0600X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adult Day Care

Taxonomy Definition

Definition to come...

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1871003335 Center for Seniors Clinic/Center 8900 Capitol Dr, Wheeling, IL 60090-7203 2017-10-10
1336689322 St. John's Lutheran Church, Inc. Clinic/Center 311 N. Lake Rd., Lena, IL 61048-8712 2017-02-24
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1598218604 3ys Service, Inc Clinic/Center 914 E 54th St, Chicago, IL 60615-5018 2016-07-26
1700281011 Starlight Adult Day Care Dba Forever Young Adult Day Services, Inc. Clinic/Center 6700 N Lincoln Ave, Lincolnwood, IL 60712-3607 2014-10-29
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Competitor

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City KANKAKEE
Zip Code 60901

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Dataset Information

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.

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