NPIMap

Organization Active NPI

Egyptian Public and Mental Health Department

Doing business as Egyptian Health Department

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Carmi, IL
National Provider Identifier
1053588012
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
00271003 Issued in IL
Legal business name
EGYPTIAN PUBLIC AND MENTAL HEALTH DEPARTMENT
Doing business as
Egyptian Health Department
Practice address
1705 College Ave
Carmi, IL 62821-2258
Phone
(618) 382-7311
Fax
(618) 382-7552
NPI assigned
May 9, 2008
Last updated
May 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Authorized official

Name
Ms. Angie Hampton
Title
Ceo
Phone
(618) 273-3326

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 00271003 IL Primary
Community/Behavioral Health Agency 251S00000X 002710002 IL

Addresses

Primary practice location

1705 College Ave
Carmi, IL 62821-2258

Mailing address

1412 US Highway 45 N
Eldorado, IL 62930-3766
Phone (618) 273-3326

Other practice location 1

1412 US Highway 45 N
Eldorado, IL 62930-3766
Phone (618) 273-3326 ext. 2119

Other identifiers 1

IdentifierTypeStateIssuer
=========MedicaidIL

Other names 1

  • Egyptian Health Department Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Egyptian Health Department20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590624000000",
    "number": "1053588012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 US HIGHWAY 45 N",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629303766",
            "telephone_number": "618-273-3326",
            "fax_number": "618-273-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 COLLEGE AVE",
            "city": "CARMI",
            "state": "IL",
            "postal_code": "628212258",
            "telephone_number": "618-382-7311",
            "fax_number": "618-382-7552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1412 US Highway 45 N",
            "address_purpose": "LOCATION",
            "city": "Eldorado",
            "state": "IL",
            "postal_code": "629303766",
            "country_code": "US",
            "telephone_number": "618-273-3326 x2119",
            "fax_number": "618-273-2808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EGYPTIAN PUBLIC AND MENTAL HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A",
        "authorized_official_last_name": "HAMPTON",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-273-3326",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "00271003",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "002710002",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "=========",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Egyptian Health Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Egyptian Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carmi, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.