NPIMap

Organization Active NPI

Hawthorne Inn Supportive Living Facility

  • Assisted Living Facility
  • Princeton, IL
National Provider Identifier
1568669778
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
006 Issued in IL
Legal business name
HAWTHORNE INN SUPPORTIVE LIVING FACILITY
Practice address
136 N. Sixth St.
Princeton, IL 61356
Phone
(815) 875-6600
Fax
(815) 875-6005
NPI assigned
Jun 29, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Kimberly Ann Woolley
Title
Manager
Phone
(815) 875-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 006 IL Primary

Addresses

Primary practice location

136 N. Sixth St.
Princeton, IL 61356

Mailing address

136 N. Sixth St.
Princeton, IL 61356
Phone (815) 875-6600

National Provider Directory

National Provider Directory
Tax ID family
Residential Alternatives of Illinois Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1568669778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 N. SIXTH ST.",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "61356",
            "telephone_number": "815-875-6600",
            "fax_number": "815-875-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 N. SIXTH ST.",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "61356",
            "telephone_number": "815-875-6600",
            "fax_number": "815-875-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWTHORNE INN SUPPORTIVE LIVING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WOOLLEY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "815-875-6600",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": "006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.