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PATTERSON HOUSE INC. NPI 1548433154


NPI Information

NPI: 1548433154
Provider Name: PATTERSON HOUSE, INC.

Doing Business As: EMERALD ESTADES

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization

CLIA Number: 14D1062956

Address:
1577 E MYRTLE ST
CANTON, IL
ZIP 61520
Phone: (309) 647-6604
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PATTERSON HOUSE, INC. is an intermediate care facility mentally retarded in Canton, IL. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. PATTERSON HOUSE, INC. NPI is 1548433154. The provider is registered as an organization entity type.
The provider Is Doing Business As Emerald Estades.

The provider's business location address is:

1577 E MYRTLE ST
CANTON, IL
ZIP 61520-520
Phone: (309) 647-6604
Fax: (309) 647-0440

The provider's authorized official is Marcia Rose .
The authorized official title is Rsd and has the following contact phone number (309) 647-6604.

The CLIA number assigned to this NPI record is 14D1062956 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/4/2008 and was last updated on 6/24/2008.


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
1343900000XNon-emergency Medical Transport (VAN)0039354ILLINOISNo
2315P00000XIntermediate Care Facility, Intellectual Disabilities0039354ILLINOISYes

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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