NPIMap

Organization Active NPI

Christian County Mental Health Association

  • Developmentally Disabled Services Day Training Agency
  • Taylorville, IL
National Provider Identifier
1407216252
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION
Practice address
703 McAdam Dr
Taylorville, IL 62568-2300
Phone
(217) 824-4905
Fax
(217) 824-3570
NPI assigned
Mar 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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

Authorized official

Name
Rebecca A Carroll
Title
Billing Supervisor
Phone
(217) 824-4905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

703 McAdam Dr
Taylorville, IL 62568-2300

Mailing address

PO Box 438
Taylorville, IL 62568-0438
Phone (217) 824-4905

Other identifiers 1

IdentifierTypeStateIssuer
04025MedicaidIL

Other names 1

  • CCMHA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Christian County Mental Health Association6 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.

NPI Registry JSON

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1407216252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 438",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625680438",
            "telephone_number": "217-824-4905",
            "fax_number": "217-824-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MCADAM DR",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625682300",
            "telephone_number": "217-824-4905",
            "fax_number": "217-824-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN COUNTY MENTAL HEALTH ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "217-824-4905"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04025",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCMHA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taylorville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.