NPIMap

Organization Active NPI

North Central Behavioral Health Systems, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Streator, IL
National Provider Identifier
1780108985
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
04107 Issued in IL
Legal business name
NORTH CENTRAL BEHAVIORAL HEALTH SYSTEMS, INC.
Practice address
111 Spring St Ste 320-328
Streator, IL 61364-3332
Phone
(815) 223-0160
NPI assigned
Jul 29, 2017
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Larry Block, CPA
Title
Cfo
Phone
(815) 224-5001

National Provider Directory

National Provider Directory
Tax ID family
North Central Behavioral Health Systems Inc29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 04107 IL Primary

Addresses

NPPES NPI Registry

Primary practice location

111 Spring St Ste 320-328
Streator, IL 61364-3332

Mailing address

PO Box 1488
La Salle, IL 61301-3488
Phone (815) 223-0160

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
04107MedicaidIL

Other names 1

NPPES NPI Registry
  • North Central Stretor DMH Medicaid Former legal business name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 13, 2020.

{
    "created_epoch": "1501286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584057600000",
    "number": "1780108985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1488",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613013488",
            "telephone_number": "815-223-0160",
            "fax_number": "815-223-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SPRING ST STE 320-328",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613643332",
            "telephone_number": "815-223-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CENTRAL BEHAVIORAL HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-29",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A",
        "authorized_official_last_name": "BLOCK",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "815-224-5001",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "04107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04107",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Central Stretor DMH Medicaid",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Streator, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.