NPIMap

Organization Active NPI

Alpha Omega Consulting, Inc.

Doing business as Southside Manor

  • Intellectual Disabilities Intermediate Care Facility
  • Decatur, IL
National Provider Identifier
1487788311
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
0046961 Issued in IL
Legal business name
ALPHA OMEGA CONSULTING, INC.
Doing business as
Southside Manor
Practice address
729 S Webster St
Decatur, IL 62521-2672
Phone
(217) 422-5478
Fax
(217) 422-2143
NPI assigned
Mar 15, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Ms. Angela Cornell
Title
President
Phone
(217) 422-4725

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 0046961 IL Primary

Addresses

Primary practice location

729 S Webster St
Decatur, IL 62521-2672

Mailing address

729 S Webster St
Decatur, IL 62521-2672
Phone (217) 422-5478

Other names 1

  • Southside Manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Alpha Omega Consulting Inc6 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.

Locations

729 S Webster St
Decatur, IL 62521
Phone (217) 422-5478

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487788311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 S WEBSTER ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625212672",
            "telephone_number": "217-422-5478",
            "fax_number": "217-422-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 S WEBSTER ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625212672",
            "telephone_number": "217-422-5478",
            "fax_number": "217-422-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA OMEGA CONSULTING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CORNELL",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-422-4725",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": "0046961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southside Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, 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.