NPIMap

Organization Active NPI

Garden of Prayer Youth Center Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kankakee, IL
National Provider Identifier
1588252159
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
GARDEN OF PRAYER YOUTH CENTER INCORPORATED
Practice address
657 E Court St Ste 200
Kankakee, IL 60901-4071
Phone
(815) 933-2493
NPI assigned
Jan 8, 2021
Organization subpart
Yes
Parent organization
GARDEN OF PRAYER YOUTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Authorized official

Name
Michael Maloney, LCPC
Title
Executive Director
Phone
(815) 933-2493

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

657 E Court St Ste 200
Kankakee, IL 60901-4071

Mailing address

657 E Court St Ste 200
Kankakee, IL 60901-4071
Phone (815) 933-2493

National Provider Directory

National Provider Directory
Tax ID family
Garden of Prayer Youth Center3 organizations share this tax ID, including this one
Part of
Garden of Prayer Youth Center

Other organizations with this tax ID 2

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": "1610064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1588252159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 E COURT ST STE 200",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609014071",
            "telephone_number": "815-933-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 E COURT ST STE 200",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609014071",
            "telephone_number": "815-933-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN OF PRAYER YOUTH CENTER INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GARDEN OF PRAYER YOUTH CENTER",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "MALONEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "815-933-2493",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.