Organization Active NPI

Kccdd, Inc.

  • Adult Mental Health Clinic/Center
  • Galesburg, IL
National Provider Identifier
1083557060
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
KCCDD, INC.
Practice address
2015 Windish Dr
Galesburg, IL 61401-9774
Phone
(309) 344-2600
Fax
(309) 344-1754
NPI assigned
Apr 13, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Authorized official

Name
Jeffrey Neal Gomer, CMA,CIA,CFM,CBM
Title
Chief Financial Officer
Phone
(309) 344-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

2015 Windish Dr
Galesburg, IL 61401-9774

Mailing address

2015 Windish Dr
Galesburg, IL 61401-9774
Phone (309) 344-2600

National Provider Directory

National Provider Directory
Tax ID family
Kccdd 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.

NPI Registry JSON

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

{
    "created_epoch": "1776038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776038400000",
    "number": "1083557060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 WINDISH DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614019774",
            "telephone_number": "309-344-2600",
            "fax_number": "309-344-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 WINDISH DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614019774",
            "telephone_number": "309-344-2600",
            "fax_number": "309-344-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KCCDD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-13",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A",
        "authorized_official_last_name": "GOMER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "NEAL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "309-344-2600",
        "authorized_official_credential": "CMA,CIA,CFM,CBM"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; 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.