NPIMap

Organization Active NPI

The William M Bedell Achievement and Resource Center

  • Developmentally Disabled Services Day Training Agency
  • Wood River, IL
National Provider Identifier
1053473801
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
THE WILLIAM M BEDELL ACHIEVEMENT AND RESOURCE CENTER
Practice address
400 S Main St
Wood River, IL 62095
Phone
(618) 251-2175
Fax
(618) 251-6294
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Gary J Osborne
Title
Executive Director
Phone
(618) 251-2175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

400 S Main St
Wood River, IL 62095

Mailing address

Box 349
400 S Main St
Wood River, IL 62095
Phone (618) 251-2175

National Provider Directory

National Provider Directory

Locations

400 S Main St
Wood River, IL 62095
Phone (618) 251-2175

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053473801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 349",
            "address_2": "400 S MAIN ST",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "62095",
            "telephone_number": "618-251-2175",
            "fax_number": "618-251-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S MAIN ST",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "62095",
            "telephone_number": "618-251-2175",
            "fax_number": "618-251-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WILLIAM M BEDELL ACHIEVEMENT AND RESOURCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-251-2175",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wood River, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.