NPIMap

Organization Active NPI

Garden of Prayer Youth Center

  • Community/Behavioral Health Agency
  • Kankakee, IL
National Provider Identifier
1184028342
Registry record updated Oct 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
442707 Issued in IL
Legal business name
GARDEN OF PRAYER YOUTH CENTER
Practice address
1432 S 4TH Ave
Kankakee, IL 60901-4931
Phone
(815) 933-2493
Fax
(815) 933-2494
NPI assigned
Oct 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2014

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

Authorized official

Name
Michael A Maloney, LCPC
Title
Executive Director
Phone
(815) 933-2493

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X IL
Community/Behavioral Health Agency 251S00000X 442707 IL Primary

Addresses

Primary practice location

1432 S 4TH Ave
Kankakee, IL 60901-4931

Mailing address

657 E Court St
Suite 200
Kankakee, IL 60901-4055
Phone (815) 933-2493

National Provider Directory

National Provider Directory
Tax ID family
Garden of Prayer Youth Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1432 S 4th Ave
Kankakee, IL 60901
Phone (815) 933-2493

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413849600000",
    "number": "1184028342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 E COURT ST",
            "address_2": "SUITE 200",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609014055",
            "telephone_number": "815-933-2493",
            "fax_number": "815-933-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 S 4TH AVE",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609014931",
            "telephone_number": "815-933-2493",
            "fax_number": "815-933-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN OF PRAYER YOUTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-21",
        "status": "A",
        "authorized_official_last_name": "MALONEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "815-933-2493",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "442707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; 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.