Occupational Development Center

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

OCCUPATIONAL DEVELOPMENT CENTER

Practice address

360 Wylie Dr
Normal, IL 61761-5500

Phone

(309) 820-0723

NPI assigned

Oct 15, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Matt Jackson

Title

President/Ceo

Phone

(309) 820-0723

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1659569788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 WYLIE DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 WYLIE DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615500",
            "telephone_number": "309-820-0723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCCUPATIONAL DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "309-820-0723",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Normal, IL
• Developmentally Disabled Services Day Training Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.