MOULTRIE COUNTY BEACON NPI 1639356017

NPI Information

  • NPI: 1639356017
  • Provider Name: MOULTRIE COUNTY BEACON
  • Classification: Day Training, Developmentally Disabled Services - 251C00000X
  • Entity Type: Organization
  • Address: 401 W WATER ST
    SULLIVAN, IL
    ZIP 61951
  • Phone: (217) 728-7396

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NPI Details

MOULTRIE COUNTY BEACON is a day training developmentally disabled services in Sullivan, IL. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. MOULTRIE COUNTY BEACON NPI is 1639356017. The provider is registered as an organization entity type.

The provider's business location address is:

401 W WATER ST
SULLIVAN, IL
ZIP 61951-883
Phone: (217) 728-7396
Fax: (217) 728-2217

The provider's authorized official is Linda Kathy Thomas .
The authorized official title is Developmental Therapist and has the following contact phone number (217) 728-7396.

The enumeration date for this NPI number is 1/28/2008 and was last updated on 7/21/2022.

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
1251C00000XDay Training, Developmentally Disabled Services001ILLINOISYes

What is NPI?

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This page was last updated on: 11/21/2025

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