ILLINOIS MENTOR NPI 1326376591

NPI Information

NPI: 1326376591
Provider Name: ILLINOIS MENTOR
Classification: Foster Care Agency - 253J00000X
Entity Type: Organization
Doing Business As: O'FALLON SITE 014010
Address: 791 WALL ST
O FALLON, IL
ZIP 62269
Phone: (618) 628-9424

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NPI Details

ILLINOIS MENTOR is a foster care agency in O Fallon, IL. The provider is a Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as 24-hour substitute care for children outside their own homes. Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes. ILLINOIS MENTOR NPI is 1326376591. The provider is registered as an organization entity type.
The provider Is Doing Business As O'fallon Site 014010.

The provider's business location address is:

791 WALL ST
O FALLON, IL
ZIP 62269-959
Phone: (618) 628-9424
Fax: (618) 628-9426

The provider's authorized official is Viviane Ngwa .
The authorized official title is Executive Director and has the following contact phone number (708) 679-9137.

The enumeration date for this NPI number is 11/30/2009 and was last updated on 11/30/2009.

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	Primary
1	251B00000X	Case Management	No
2	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities	No
3	253J00000X	Foster Care Agency	Yes

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: 11/21/2025

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