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BROTHER JAMES COURT NPI 1386778462


NPI Information

NPI: 1386778462
Provider Name: BROTHER JAMES COURT
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
2508 SAINT JAMES RD
SPRINGFIELD, IL
ZIP 62707
Phone: (217) 544-4876
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BROTHER JAMES COURT is a residential treatment facility, intellectual and/or developmental disabilities in Springfield, IL. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. BROTHER JAMES COURT NPI is 1386778462. The provider is registered as an organization entity type.

The provider's business location address is:

2508 SAINT JAMES RD
SPRINGFIELD, IL
ZIP 62707-736
Phone: (217) 544-4876
Fax: (217) 747-5914

The provider's authorized official is Ron Wampler .
The authorized official title is Administator and has the following contact phone number (217) 747-5900.

The enumeration date for this NPI number is 3/14/2007 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental Disabilities0020495ILLINOISYes

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
114G039MEDICAIDILLINOIS

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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