Alvin Eades Center, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

0040220 Issued in IL

Legal business name

ALVIN EADES CENTER, INC.

Practice address

1000A W Michigan Ave
Jacksonville, IL 62650-3117

Phone

(217) 245-9898

Fax

(217) 243-7966

NPI assigned

Feb 21, 2008

Organization subpart

Yes

Parent organization

ALVIN EADES CENTER, INC.As reported in NPPES

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

Authorized official

Name

Mr. Brad Barnes

Title

Executive Director

Phone

(217) 245-9898

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Alvin Eades Center Inc2 organizations share this tax ID, including this one

Part of

Alvin Eades Center Inc

Other organizations with this tax ID 1

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

• Alvin Eades Center Inc

  • Developmental Disabilities Clinic/Center
  • Jacksonville, IL
  • NPI 1710432968
  NPD tax ID

Locations

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471996800000",
    "number": "1609045897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 W SUPERIOR AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503117",
            "telephone_number": "217-245-9898",
            "fax_number": "217-243-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000A W MICHIGAN AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503117",
            "telephone_number": "217-245-9898",
            "fax_number": "217-243-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALVIN EADES CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALVIN EADES CENTER, INC.",
        "enumeration_date": "2008-02-21",
        "last_updated": "2016-08-24",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "217-245-9898",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": "0040220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710432968",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Albrecht, APRN, FNP-C
• Joan M. Alexander, R.N.
• Bethany Allen
• Brandynne Marie Fry Allgaier, FNP-C, APRN
• Alvin Eades Center Inc
• American Oxygen and Medical Equipment, Inc
• Braden G. Anderson, OD
• Anesthesia Care Associates, LLC
• Arc of Jacksonville, LTD
• Arcadia Care Jacksonville LLC

• Intellectual Disabilities Intermediate Care Facility in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Intellectual Disabilities Intermediate Care Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.