BRETHREN HOME NPI 1548412976

NPI Information

  • NPI: 1548412976
  • Provider Name: BRETHREN HOME
  • Classification: Private Vehicle - 347C00000X
  • Entity Type: Organization
  • Doing Business As: PINECREST MANOR
  • Address: 414 S WESLEY AVE
    MOUNT MORRIS, IL
    ZIP 61054
  • Phone: (815) 734-4103

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NPI Details

BRETHREN HOME is a private vehicle in Mount Morris, IL. The provider is an individual paid to provide non-emergency transportation using their privately owned/leased vehicle. BRETHREN HOME NPI is 1548412976. The provider is registered as an organization entity type.
The provider Is Doing Business As Pinecrest Manor.

The provider's business location address is:

414 S WESLEY AVE
MOUNT MORRIS, IL
ZIP 61054-428
Phone: (815) 734-4103
Fax: (815) 734-7318

The provider's authorized official is Carol A Davis .
The authorized official title is Ceo/administrator and has the following contact phone number (815) 734-4103.

The enumeration date for this NPI number is 10/16/2008 and was last updated on 1/20/2009.

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 Taxonomy Specialization License Number License State Primary
1347C00000XPrivate VehicleYes

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
114-5024MEDICARE PINILLINOIS
2=========001MEDICAIDILLINOIS

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

NPI Synchronization or Removal

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