NPIMap

Organization Active NPI

Kreider Services Inc

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Ashton, IL
National Provider Identifier
1104158153
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
41152 Issued in IL
Legal business name
KREIDER SERVICES INC
Practice address
407 N 1St St
Ashton, IL 61006-9476
Phone
(815) 453-2074
NPI assigned
Feb 2, 2010
Last updated
Aug 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Authorized official

Name
Mr. Jeffrey J Stauter
Title
Executive Director
Phone
(815) 288-6691

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 41152 IL Primary

Addresses

Primary practice location

407 N 1St St
Ashton, IL 61006-9476

Mailing address

PO Box 366
Dixon, IL 61021-0366
Phone (815) 288-6691

Other names 1

  • First Street Group Home Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104158153. Details of each certification follow.

  • CCN 14G357 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 14G357

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
FIRST STREET GROUP HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Feb 1, 1996
Last certification
Jan 23, 2025
Beds
4
Ownership / control type
Private (non-profit)
Facility address
407 North First Street
Ashton, IL 61006

National Provider Directory

National Provider Directory
Tax ID family
Kreider Services Inc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1104158153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 366",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610210366",
            "telephone_number": "815-288-6691",
            "fax_number": "815-288-1636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N 1ST ST",
            "city": "ASHTON",
            "state": "IL",
            "postal_code": "610069476",
            "telephone_number": "815-453-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KREIDER SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-02",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "STAUTER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "815-288-6691",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "41152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Street Group Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ashton, IL

Sources for this page

Verify at the official NPI Registry.