NPIMap

Organization Active NPI

Patterson House Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Carlinville, IL
National Provider Identifier
1629424312
Registry record updated May 11, 2016
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
PATTERSON HOUSE INC
Practice address
522 S Broad St
Carlinville, IL 62626-2114
Phone
(217) 930-2135
NPI assigned
May 11, 2016
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Jennifer Haseley
Title
Office Manager
Phone
(217) 422-6510

Corporate family (same tax ID) 5

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

National Provider Directory

National Provider Directory
Tax ID family
Patterson House Inc (6 organizations share this tax ID)

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

522 S Broad St
Carlinville, IL 62626-2114

Mailing address

636 W Imboden Dr
Decatur, IL 62521-9067
Phone (217) 422-6510

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 11, 2016.

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462924800000",
    "number": "1629424312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 W IMBODEN DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625219067",
            "telephone_number": "217-422-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 S BROAD ST",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626262114",
            "telephone_number": "217-930-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATTERSON HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-11",
        "last_updated": "2016-05-11",
        "status": "A",
        "authorized_official_last_name": "HASELEY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "217-422-6510"
    },
    "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 Carlinville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.