Hoosier Care, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

0035469 Issued in IL

Legal business name

HOOSIER CARE, INC.

Doing business as

Walter Lawson Children's Home

Practice address

1820 Walter Lawson Dr
Loves Park, IL 61111-2757

Phone

(815) 633-6636

Fax

(815) 633-6387

NPI assigned

May 24, 2006

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

Ms. Theo Ann Brandel, R.N.

Title

Executive Director

Phone

(815) 633-6636

Specialties & licenses 1

Addresses

Other names 1

• Walter Lawson Children's Home Doing business as

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 1346295631. Details of each certification follow.

• CCN 14G243 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 14G243

Legal name

WALTER LAWSON CHILDREN'S HOME

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Jul 16, 1990

Last certification

Oct 31, 2024

Beds

99

Ownership / control type

Private (non-profit)

Facility address

1820 Walter Lawson Drive
Loves Park, IL 61111

Tax ID family

Hoosier Care6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

• Hoosier Care

  dba Exceptional Care & Training Center

  • Pediatric Skilled Nursing Facility
  • Sterling, IL
  • NPI 1285747006
  NPD tax ID
• Hoosier Care

  dba Swann Special Care

  • Pediatric Skilled Nursing Facility
  • Champaign, IL
  • NPI 1306859731
  NPD tax ID
• Hoosier Care

  dba Walter Lawson Children's Home

  • Pediatric Skilled Nursing Facility
  • Loves Park, IL
  • NPI 1578676391
  NPD tax ID
• Hoosier Care Inc

  dba Exceptional Care & Training Center

  • Pediatric Skilled Nursing Facility
  • Sterling, IL
  • NPI 1316975212
  NPD tax ID
• Hoosier Care Inc.

  dba Swann Special Care Center

  • Developmentally Disabled Services Day Training Agency
  • Champaign, IL
  • NPI 1326582701
  NPD tax ID

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346295631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 WALTER LAWSON DR",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112757",
            "telephone_number": "815-633-6636",
            "fax_number": "815-633-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 WALTER LAWSON DR",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112757",
            "telephone_number": "815-633-6636",
            "fax_number": "815-633-6387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOOSIER CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRANDEL",
        "authorized_official_first_name": "THEO",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "815-633-6636",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": "0035469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walter Lawson Children's Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roger H Hill, OD
• Kaari L Hobson, LCSW
• Shalise Marie Holt, DDS, MS
• Victoria M. Hominick, LCSW
• Hoosier Care (Walter Lawson Children's Home)
• Cheryl Lynn Horkheimer, LMT
• Jason Huffman, CRNA
• Jennifer Huls, LMT
• HV Modern Wellness
• Ibrahim Ibrahim, M.D.

• Intellectual Disabilities Intermediate Care Facility in Loves Park, IL
• Providers in Loves Park, IL by specialty
• Intellectual Disabilities Intermediate Care Facility 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.