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ELDERCARE INC NPI 1982686093


NPI Information

NPI: 1982686093
Provider Name: ELDERCARE INC

Doing Business As: CALVIN JOHNSON CARE CENTER

Classification: Skilled Nursing Facility - 314000000X
Entity Type: Organization
Address:
727 N 17TH ST
BELLEVILLE, IL
ZIP 62226
Phone: (618) 234-3323
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ELDERCARE INC is a skilled nursing facility in Belleville, IL. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. ELDERCARE INC NPI is 1982686093. The provider is registered as an organization entity type.
The provider Is Doing Business As Calvin Johnson Care Center.

The provider's business location address is:

727 N 17TH ST
BELLEVILLE, IL
ZIP 62226-552
Phone: (618) 234-3323
Fax: (618) 234-9477

The provider's authorized official is Steven C Wolf .
The authorized official title is President and has the following contact phone number (618) 234-2273.

The enumeration date for this NPI number is 11/15/2005 and was last updated on 4/20/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1314000000XSkilled Nursing Facility0023309ILLINOISYes
2291U00000XClinical Medical LaboratoryILLINOISNo

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========001MEDICAIDILLINOIS
2145290MEDICARE OSCAR/CERTIFICATION
30263120001MEDICARE NSC
4V255P6570911OTHERVA VETERANS ADMIN
5145290MEDICARE ID-TYPE UNSPECIFIED

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: 4/28/2024

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