Meadows Mennonite Retirement Community Association, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0011544 Issued in IL

Legal business name

MEADOWS MENNONITE RETIREMENT COMMUNITY ASSOCIATION, INC.

Practice address

24588 Church St
Chenoa, IL 61726-9395

Phone

(309) 747-2702

Fax

(309) 747-2944

NPI assigned

Jun 16, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Robert O. Bertsche

Title

Administrator Ceo

Phone

(309) 747-2702

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Meadows Mennonite Home Doing business as

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Meadows Mennonite Retirement Community

  • Bus
  • Chenoa, IL
  • NPI 1699949834
  NPPES parent name

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1831194752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24588 CHURCH ST",
            "city": "CHENOA",
            "state": "IL",
            "postal_code": "617269395",
            "telephone_number": "309-747-2702",
            "fax_number": "309-747-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24588 CHURCH ST",
            "city": "CHENOA",
            "state": "IL",
            "postal_code": "617269395",
            "telephone_number": "309-747-2702",
            "fax_number": "309-747-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWS MENNONITE RETIREMENT COMMUNITY ASSOCIATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "BERTSCHE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "ADMINISTRATOR CEO",
        "authorized_official_telephone_number": "309-747-2702",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": "0011544",
            "primary": false
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "IL",
            "license": "0011544",
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IL",
            "license": "0011544",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0011544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11544",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meadows Mennonite Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Chenoa, IL
• Providers in Chenoa, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.