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CLAY COUNTY REHABILITATION CENTER INC. NPI 1104047208


NPI Information

NPI: 1104047208
Provider Name: CLAY COUNTY REHABILITATION CENTER, INC.

Former Legal Business Name: FLORA OPPORTUNITY CENTER

Classification: Day Training, Developmentally Disabled Services - 251C00000X
Entity Type: Organization

CLIA Number: 14D2238449

Address:
530 W 4TH ST
FLORA, IL
ZIP 62839
Phone: (618) 662-4916
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CLAY COUNTY REHABILITATION CENTER, INC. is a day training developmentally disabled services in Flora, IL. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. CLAY COUNTY REHABILITATION CENTER, INC. NPI is 1104047208. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Flora Opportunity Center.

The provider's business location address is:

530 W 4TH ST
FLORA, IL
ZIP 62839-213
Phone: (618) 662-4916
Fax: (618) 662-9354

The provider's authorized official is Gary Whitehead .
The authorized official title is Executive Director and has the following contact phone number (618) 662-4916.

The CLIA number assigned to this NPI record is 14D2238449 - other - community day services with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/2/2007 and was last updated on 8/22/2020.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251C00000XDay Training, Developmentally Disabled ServicesILLINOISYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10371OTHERILLINOISDAY TRAINING AGENCY ID

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: 5/5/2024

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