Kemmerer Village Inc.
Organization Active NPI Emotionally Disturbed Childrens' Residential Treatment Facility · Assumption, IL
NPI 1811965239 · NPPES record last updated Sep 20, 2018
Key facts
- NPI
- 1811965239
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
- License
- 0011289-10 (IL)
- Legal business name
- KEMMERER VILLAGE INC.
- Practice address
- 941 N. 2500 East. Rd.
Assumption, IL 62510 - Phone
- (217) 226-4451
- Fax
- (217) 226-3511
- NPI assigned
- Mar 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Ronald Little
- Title
- Executive Director
- Phone
- (217) 226-2116
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Kemmerer Village Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | 0011289-10 | IL | Yes |
Addresses
Primary practice location
941 N. 2500 East. Rd.
Assumption, IL 62510
Mailing address
941 N. 2500 East. Rd.
Assumption, IL 62510
Phone (217) 226-4451
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00112895116 | Other | IL | DCFS CONTRACT NUMBER |
| 0112895113 | Other | RESIDENTIAL CONTRACT | |
| 3B00IPI041 | Medicaid | IL | |
| 3B00-IPI-041 | Medicaid | IL |
Other providers in Assumption, IL
- Apex Physical Therapy, LLC
- Assumption Fire Protection District
- Central a and M Community Unit
- Jaclyn Davis
- Kemmerer Village Inc.
- Metzger Health Care Pharmacy
- Amber Miller
- Pana Community Hospital Association
- Pana Community Hospital Association
- Pana Community Hospital Association
All providers in Assumption, IL · Emotionally Disturbed Childrens' Residential Treatment 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 Sep 20, 2018. 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.