NPIMap

Organization Active NPI

Illinois Department of Human Services

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Centralia, IL
National Provider Identifier
1639214760
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
805-8000 Issued in IL
Legal business name
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Practice address
1535 W McCord St
Centralia, IL 62801-5805
Phone
(618) 532-1811
Fax
(618) 532-7464
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Mr. James Veach
Title
Center Director
Phone
(618) 532-1811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 805-8000 IL Primary

Addresses

Primary practice location

1535 W McCord St
Centralia, IL 62801-5805

Mailing address

1535 W McCord St
Centralia, IL 62801-5805
Phone (618) 532-1811

Other identifiers 1

IdentifierTypeStateIssuer
000584061001MedicaidIL

Other names 1

  • Murray Developmental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Howe Center - Unit 4264292 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1639214760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 W MCCORD ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628015805",
            "telephone_number": "618-532-1811",
            "fax_number": "618-532-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 W MCCORD ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628015805",
            "telephone_number": "618-532-1811",
            "fax_number": "618-532-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS DEPARTMENT OF HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "VEACH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CENTER DIRECTOR",
        "authorized_official_telephone_number": "618-532-1811",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "805-8000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000584061001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Murray Developmental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centralia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.