ILLINOIS VETERANS HOME AT ANNA NPI 1326105636

NPI Information

NPI: 1326105636
Provider Name: ILLINOIS VETERANS HOME AT ANNA
Classification: Residential Treatment Facility, Physical Disabilities - 320700000X
Entity Type: Organization

CLIA Number: 14D0891028

Address:
792 N MAIN ST
ANNA, IL
ZIP 62906
Phone: (618) 833-6302
Get Directions

ILLINOIS VETERANS HOME AT ANNA is a residential treatment facility physical disabilities in Anna, IL. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently. ILLINOIS VETERANS HOME AT ANNA NPI is 1326105636. The provider is registered as an organization entity type.

The provider's business location address is:

792 N MAIN ST
ANNA, IL
ZIP 62906-627
Phone: (618) 833-6302
Fax: (618) 833-3603

The provider's authorized official is Robert S Emling .
The authorized official title is Administrator and has the following contact phone number (618) 833-3602.

The CLIA number assigned to this NPI record is 14D0891028 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/3/2007 and was last updated on 2/8/2012.

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
1	332B00000X	Durable Medical Equipment & Medical Supplies				No
2	311ZA0620X	Custodial Care Facility	Adult Care Home	0046599	ILLINOIS	No
3	320700000X	Residential Treatment Facility, Physical Disabilities		0046599	ILLINOIS	Yes

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 Issuer
1	5041900001	MEDICARE NSC
2	DC1501	MEDICARE PIN
3	208774	MEDICARE PIN
4	09132008	OTHER	BCBS

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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