NPIMap

Organization Active NPI

Beverly Farm Foundation

  • Intellectual Disabilities Intermediate Care Facility
  • Godfrey, IL
National Provider Identifier
1376618082
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
0036947 Issued in IL
Legal business name
BEVERLY FARM FOUNDATION
Practice address
212 Bachman LN
Godfrey, IL 62035-2122
Phone
(618) 466-0367
Fax
(618) 466-3652
NPI assigned
Nov 21, 2006
Last updated
Aug 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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

Authorized official

Name
Mrs. Brenda Miller
Title
Finance Director
Phone
(618) 466-0367

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 0036947 IL Primary

Addresses

Primary practice location

212 Bachman LN
Godfrey, IL 62035-2122

Mailing address

6301 Humbert Rd
Godfrey, IL 62035-2163
Phone (618) 466-0367

National Provider Directory

National Provider Directory
Tax ID family
Beverly Farm Foundation7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472083200000",
    "number": "1376618082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 HUMBERT RD",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620352163",
            "telephone_number": "618-466-0367",
            "fax_number": "618-466-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 BACHMAN LN",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620352122",
            "telephone_number": "618-466-0367",
            "fax_number": "618-466-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY FARM FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2016-08-25",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "618-466-0367",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": "0036947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Godfrey, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.