NPIMap

Organization Active NPI

United Methodist Children's Home of Southern Illinois Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Mount Vernon, IL
National Provider Identifier
1619146115
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
021068-11 Issued in IL
Legal business name
UNITED METHODIST CHILDREN'S HOME OF SOUTHERN ILLINOIS INC.
Practice address
2023 Richview Rd
Mount Vernon, IL 62864-2884
Phone
(618) 242-1070
Fax
(618) 242-9381
NPI assigned
Feb 28, 2008
Last updated
Feb 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Authorized official

Name
Mr. Clete P Winkelmann, M.S.
Title
President/Ceo
Phone
(618) 242-1070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 021068-11 IL Primary

Addresses

Primary practice location

2023 Richview Rd
Mount Vernon, IL 62864-2884

Mailing address

2023 Richview Rd
Mount Vernon, IL 62864-2884
Phone (618) 242-1070

Other identifiers 1

IdentifierTypeStateIssuer
5000-IPI-09MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Spero Family Services8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1619146115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 RICHVIEW RD",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642884",
            "telephone_number": "618-242-1070",
            "fax_number": "618-242-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 RICHVIEW RD",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642884",
            "telephone_number": "618-242-1070",
            "fax_number": "618-242-9381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED METHODIST CHILDREN'S HOME OF SOUTHERN ILLINOIS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "WINKELMANN",
        "authorized_official_first_name": "CLETE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "618-242-1070",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "IL",
            "license": "021068-11",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5000-IPI-09",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; 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.