Beverly Farm Foundation
Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Godfrey, IL
NPI 1710051545 · NPPES record last updated Aug 25, 2016
Key facts
- NPI
- 1710051545
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual Disabilities Intermediate Care Facility 315P00000X
- License
- 0037614 (IL)
- Legal business name
- BEVERLY FARM FOUNDATION
- Practice address
- 302 Bachman LN
Godfrey, IL 62035-2123 - Phone
- (618) 466-0367
- Fax
- (618) 466-3652
- NPI assigned
- Nov 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Brenda Miller
- Title
- Finance Director
- Phone
- (618) 466-0367
Corporate family (same tax ID) 6
National Provider Directory
- Tax ID family
- Beverly Farm Foundation
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 0037614 | IL | Yes |
Addresses
Primary practice location
302 Bachman LN
Godfrey, IL 62035-2123
Mailing address
6301 Humbert Rd
Godfrey, IL 62035-2163
Phone (618) 466-0367
Other providers in Godfrey, IL
- Beverly Farm Foundation
- Beverly Farm Foundation
- Beverly Farm Foundation
- Beverly Farm Foundation
- Beverly Farm Foundation
- Beverly Farm Foundation
- Beverly Farm Living Options
- Derrick Boyd
- Bria of Godfrey LP
- Joshua Seth Brunaugh
All providers in Godfrey, IL · Intellectual Disabilities Intermediate Care Facility in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.