NPIMap

Organization Active NPI

Cunningham Children'S Home of Urbana Il

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Urbana, IL
National Provider Identifier
1831683382
Registry record updated Jun 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
CUNNINGHAM CHILDREN'S HOME OF URBANA IL
Practice address
1301 N Cunningham Ave
Urbana, IL 61802-1830
Phone
(217) 367-3728
Fax
(217) 367-2896
NPI assigned
Jun 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2018

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

Authorized official

Name
Shawn Suzette Peterson
Title
Director of Quality Improvement
Phone
(217) 367-3728

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

1301 N Cunningham Ave
Urbana, IL 61802-1830

Mailing address

1301 N Cunningham Ave
Urbana, IL 61802-1830
Phone (217) 367-3728

Other names 1

  • Goodman (Building/Program) Other name

National Provider Directory

National Provider Directory
Tax ID family
Cunningham Children'S Home of Urbana Il10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529366400000",
    "number": "1831683382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 N CUNNINGHAM AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618021830",
            "telephone_number": "217-367-3728",
            "fax_number": "217-367-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N CUNNINGHAM AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618021830",
            "telephone_number": "217-367-3728",
            "fax_number": "217-367-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUNNINGHAM CHILDREN'S HOME OF URBANA IL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-19",
        "last_updated": "2018-06-19",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "SUZETTE",
        "authorized_official_title_or_position": "DIRECTOR OF QUALITY IMPROVEMENT",
        "authorized_official_telephone_number": "217-367-3728"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goodman (Building/Program)",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Goodman (Building/Program)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.