NPIMap

Organization Active NPI

Willowglen Academy-Il, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Freeport, IL
National Provider Identifier
1598097016
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
WILLOWGLEN ACADEMY-IL, INC.
Practice address
564 N Greenfield Dr
Freeport, IL 61032-2943
Phone
(815) 233-6162
NPI assigned
Feb 9, 2010
Organization subpart
Yes
Parent organization
PHOENIX CARE SYSTEMSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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

Authorized official

Name
Mrs. Betty Kinard
Title
Executive Director
Phone
(815) 233-6162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

564 N Greenfield Dr
Freeport, IL 61032-2943

Mailing address

701 W Lamm Rd
Freeport, IL 61032-9630

National Provider Directory

National Provider Directory
Tax ID family
Broadstep Academy-Illinois Inc39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

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

View all 38

Locations

701 W Lamm Rd
Freeport, IL 61032
Phone (815) 233-6162

NPI Registry JSON

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

{
    "created_epoch": "1265673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265673600000",
    "number": "1598097016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W LAMM RD",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610329630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 N GREENFIELD DR",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610322943",
            "telephone_number": "815-233-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWGLEN ACADEMY-IL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOENIX CARE SYSTEMS",
        "enumeration_date": "2010-02-09",
        "last_updated": "2010-02-09",
        "status": "A",
        "authorized_official_last_name": "KINARD",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "815-233-6162",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; 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.