NPIMap

Organization Active NPI

Mental Health Centers of Central Illinois

Doing business as Memorial Behavioral Health - Springfield Residential Center (Bldg B)

  • Mental Illness Community Based Residential Treatment Facility
  • Springfield, IL
National Provider Identifier
1659525863
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
Doing business as
Memorial Behavioral Health - Springfield Residential Center (Bldg B)
Practice address
200 W Lake Dr
Buidling B
Springfield, IL 62703-4956
Phone
(217) 588-7931
Fax
(217) 529-9803
NPI assigned
Nov 14, 2008
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MENTAL HEALTH CENTERS OF CENTRAL ILLINOISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Ann Bowling
Title
Director
Phone
(217) 588-2626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X IL Primary

Addresses

Primary practice location

200 W Lake Dr
Buidling B
Springfield, IL 62703-4956

Mailing address

200 W Lake Dr BLDG B
Springfield, IL 62703-4956
Phone (217) 588-7931

Other names 1

  • Memorial Behavioral Health - Springfield Residential Center (Bldg B) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
C C S15 organizations share this tax ID, including this one
Part of
C C S

Other organizations with this tax ID 14

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

View all 14

Locations

200 W Lake Dr
Bldg B
Springfield, IL 62703
Phone (217) 588-7931

NPI Registry JSON

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

{
    "created_epoch": "1226620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1659525863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W LAKE DR BLDG B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627034956",
            "telephone_number": "217-588-7931",
            "fax_number": "217-529-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W LAKE DR",
            "address_2": "BUIDLING B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627034956",
            "telephone_number": "217-588-7931",
            "fax_number": "217-529-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS",
        "enumeration_date": "2008-11-14",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "BOWLING",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "217-588-2626"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Behavioral Health - Springfield Residential Center (Bldg B)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Behavioral Health - Springfield Residential Center (Bldg B)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.