West Grove, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

0033548 Issued in IL

Legal business name

WEST GROVE, INC

Practice address

RR 1 Box 417
Lawrenceville, IL 62439-9796

Phone

(618) 943-7597

Fax

(618) 943-3218

NPI assigned

Mar 16, 2007

Last updated

Aug 22, 2020By 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

Mr. Robert William Gillis

Title

Administrator

Phone

(618) 945-2091

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124152384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 417",
            "city": "LAWRENCEVILLE",
            "state": "IL",
            "postal_code": "624399796",
            "telephone_number": "618-943-7597",
            "fax_number": "618-943-3218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 417",
            "city": "LAWRENCEVILLE",
            "state": "IL",
            "postal_code": "624399796",
            "telephone_number": "618-943-7597",
            "fax_number": "618-943-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST GROVE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GILLIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-945-2091",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "0033548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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.