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ILLINOIS DEPARTMENT OF HUMAN SERVICES NPI 1083620827


NPI Information

NPI: 1083620827
Provider Name: ILLINOIS DEPARTMENT OF HUMAN SERVICES

Doing Business As: ALTON MENTAL HEALTH CENTER

Classification: Psychiatric Hospital - 283Q00000X
Entity Type: Organization

CLIA Number: 14D0931699

Address:
4500 COLLEGE AVE
ALTON, IL
ZIP 62002
Phone: (618) 474-3800
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ILLINOIS DEPARTMENT OF HUMAN SERVICES is a psychiatric hospital in Alton, IL. The provider is an organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. ILLINOIS DEPARTMENT OF HUMAN SERVICES NPI is 1083620827. The provider is registered as an organization entity type.
The provider Is Doing Business As Alton Mental Health Center.

The provider's business location address is:

4500 COLLEGE AVE
ALTON, IL
ZIP 62002
Phone: (618) 474-3800

The provider's authorized official is Tonya Piephoff .
The authorized official title is Hospital Administrator and has the following contact phone number (618) 474-3473.

The CLIA number assigned to this NPI record is 14D0931699 - hospital with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/1/2006 and was last updated on 8/21/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1283Q00000XPsychiatric HospitalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000194572001MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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