Organization Active NPI

Wells Center Inc

  • Substance Abuse Rehabilitation Facility
  • Jacksonville, IL
National Provider Identifier
1205933561
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
A0613007A Issued in IL
Legal business name
WELLS CENTER INC
Practice address
1300 Lincoln Avenue
Jacksonville, IL 62650
Phone
(217) 243-1871
Fax
(217) 243-2278
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Bruce M Carter, MPA CRADC ICADC
Title
Executive Director
Phone
(217) 243-1871

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X A0613007A IL Primary

Addresses

Primary practice location

1300 Lincoln Avenue
Jacksonville, IL 62650

Mailing address

1300 Lincoln Avenue
Jacksonville, IL 62650
Phone (217) 243-1871

Other names 1

  • Jacksonville Area Council On Alcoholism Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Wells Center Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1300 Lincoln Ave
Jacksonville, IL 62650
Phone (217) 243-1871

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205933561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 LINCOLN AVENUE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "62650",
            "telephone_number": "217-243-1871",
            "fax_number": "217-243-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 LINCOLN AVENUE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "62650",
            "telephone_number": "217-243-1871",
            "fax_number": "217-243-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "217-243-1871",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPA CRADC ICADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "IL",
            "license": "A0613007A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacksonville Area Council On Alcoholism",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Jacksonville, IL

Sources for this page

  • 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.