NPIMap

Organization Active NPI

Moultrie County Beacon, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Sullivan, IL
National Provider Identifier
1609228808
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
MOULTRIE COUNTY BEACON, INC.
Practice address
401 W Water St
Sullivan, IL 61951-1883
Phone
(217) 728-7396
Fax
(217) 728-2217
NPI assigned
Jul 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Authorized official

Name
Susan Rauch
Title
Executive Director
Phone
(217) 728-7396

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

401 W Water St
Sullivan, IL 61951-1883

Mailing address

401 W Water St
Sullivan, IL 61951-1883
Phone (217) 728-7396

National Provider Directory

National Provider Directory
Tax ID family
Moultrie County Beacon2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1468281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1609228808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W WATER ST",
            "city": "SULLIVAN",
            "state": "IL",
            "postal_code": "619511883",
            "telephone_number": "217-728-7396",
            "fax_number": "217-728-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W WATER ST",
            "city": "SULLIVAN",
            "state": "IL",
            "postal_code": "619511883",
            "telephone_number": "217-728-7396",
            "fax_number": "217-728-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOULTRIE COUNTY BEACON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-12",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "RAUCH",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "217-728-7396"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sullivan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.