CHILDREN'S HOME ASSOCIATION OF ILLINOIS NPI 1780810648

NPI Information

NPI: 1780810648
Provider Name: CHILDREN'S HOME ASSOCIATION OF ILLINOIS
Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
400 E. FRYE
PEORIA, IL
ZIP 61603
Phone: (309) 687-7103
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CHILDREN'S HOME ASSOCIATION OF ILLINOIS is a residential treatment facility emotionally disturbed children in Peoria, IL. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. CHILDREN'S HOME ASSOCIATION OF ILLINOIS NPI is 1780810648. The provider is registered as an organization entity type.

The provider's business location address is:

400 E. FRYE
PEORIA, IL
ZIP 61603
Phone: (309) 687-7103

The provider's authorized official is Patrick M. Phelan .
The authorized official title is Vp Of Operations and has the following contact phone number (304) 687-7255.

The enumeration date for this NPI number is 6/5/2009 and was last updated on 6/5/2009.

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	Primary
1	251V00000X	Voluntary or Charitable	No
2	320800000X	Community Based Residential Treatment Facility, Mental Illness	No
3	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children	Yes

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
1	=========-009	MEDICAID	ILLINOIS

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: 11/14/2023

NPI Synchronization or Removal

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