NPIMap

Organization Active NPI

Kaskaskia Workshop, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Centralia, IL
National Provider Identifier
1013054154
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
KASKASKIA WORKSHOP, INC.
Practice address
299 Swan Ave
Centralia, IL 62801
Phone
(618) 533-4423
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Greg Shaver
Title
Ceo
Phone
(618) 533-4423

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary
Early Intervention Provider Agency 252Y00000X IL

Addresses

Primary practice location

299 Swan Ave
Centralia, IL 62801

Mailing address

PO Box 1946
Centralia, IL 62801-9127

National Provider Directory

National Provider Directory
Tax ID family
Kaskaskia Workshop Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449100800000",
    "number": "1013054154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1946",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628019127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 SWAN AVE",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "62801",
            "telephone_number": "618-533-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KASKASKIA WORKSHOP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2015-12-03",
        "status": "A",
        "authorized_official_last_name": "SHAVER",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-533-4423"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.