Clay County Rehabilitation Center, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

CLAY COUNTY REHABILITATION CENTER, INC.

Practice address

530 W 4TH St
Flora, IL 62839-1213

Phone

(618) 662-4916

Fax

(618) 662-9354

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Gary Whitehead

Title

Executive Director

Phone

(618) 662-4916

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Flora Opportunity Center Former legal business name

Locations

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104047208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 W 4TH ST",
            "address_2": "P.O. BOX 659",
            "city": "FLORA",
            "state": "IL",
            "postal_code": "628391213",
            "telephone_number": "618-662-4916",
            "fax_number": "618-662-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 W 4TH ST",
            "city": "FLORA",
            "state": "IL",
            "postal_code": "628391213",
            "telephone_number": "618-662-4916",
            "fax_number": "618-662-9354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY COUNTY REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-662-4916",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAY TRAINING AGENCY ID",
            "identifier": "0371",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Flora Opportunity Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Clay County Health Department
• Clay County Health Department
• Clay County Health Dept
• Clay County Horizon Center
• Clay County Hospital
• County of Clay
• County of Clay
• County of Clay
• County of Clay
• County of Clay

• All providers in Flora, IL
• Developmentally Disabled Services Day Training Agency in Illinois

• 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.