Brethren Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1676853 Issued in IL

Legal business name

BRETHREN HOME

Doing business as

Pinecrest Manor

Practice address

414 S Wesley Ave
Mount Morris, IL 61054-1428

Phone

(815) 734-4103

Fax

(815) 734-7318

NPI assigned

Sep 15, 2005

Last updated

Mar 12, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ferol J. Labash, NHA

Title

Ceo

Phone

(815) 734-4103

Specialties & licenses 1

Addresses

Other names 1

• Pinecrest Manor Doing business as

Locations

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1083609960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 S WESLEY AVE",
            "city": "MOUNT MORRIS",
            "state": "IL",
            "postal_code": "610541428",
            "telephone_number": "815-734-4103",
            "fax_number": "815-734-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 S WESLEY AVE",
            "city": "MOUNT MORRIS",
            "state": "IL",
            "postal_code": "610541428",
            "telephone_number": "815-734-4103",
            "fax_number": "815-734-7318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRETHREN HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "LABASH",
        "authorized_official_first_name": "FEROL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "815-734-4103",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "1676853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinecrest Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Allure of Pinecrest LLC
• Aspiring Health, LTD.
• Biome Inc.
• Board of Trustees of the University of Illinois (University Primary Care Clinic at Mt Morris)
• Brethren Home (Pinecrest Manor)
• Brethren Home (Pinecrest Manor)
• Whitney Ann Cervantez, M.S. SLP
• Isaac Heonsang Cha, PHARMD, BCPS, BCADM
• Kristin Charleston, PTA

• Skilled Nursing Facility in Mount Morris, IL
• Providers in Mount Morris, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; 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.