BETHSHAN ASSOCIATION NPI 1689710121

NPI Information

NPI: 1689710121
Provider Name: BETHSHAN ASSOCIATION

Doing Business As: TIBSTRA HOUSE

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
271 E 161ST ST
SOUTH HOLLAND, IL
ZIP 60473
Phone: (708) 596-4442
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BETHSHAN ASSOCIATION is an intermediate care facility mentally retarded in South Holland, IL. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. BETHSHAN ASSOCIATION NPI is 1689710121. The provider is registered as an organization entity type.
The provider Is Doing Business As Tibstra House.

The provider's business location address is:

271 E 161ST ST
SOUTH HOLLAND, IL
ZIP 60473-400
Phone: (708) 596-4442
Fax: (708) 596-4486

The provider's authorized official is Steven J Goudzwaard .
The authorized official title is Director Of Finance and has the following contact phone number (708) 371-0800.

The enumeration date for this NPI number is 1/30/2007 and was last updated on 8/15/2016.

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
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities		0035196	ILLINOIS	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: 5/5/2024

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