Bethshan Association

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

0027086 Issued in IL

Legal business name

BETHSHAN ASSOCIATION

Practice address

12927 S Monitor Ave
Palos Heights, IL 60463-2434

Phone

(708) 371-0800

Fax

(708) 371-0833

NPI assigned

Jan 30, 2007

Last updated

Aug 15, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Steven J Goudzwaard

Title

Director of Finance

Phone

(708) 371-0800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952447443. Details of each certification follow.

• CCN 14G072 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 14G072

Legal name

BETHSHAN ASSOCIATION

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Sep 10, 1982

Last certification

Mar 28, 2025

Beds

45

Ownership / control type

Private (non-profit)

Facility address

12927 South Monitor
Palos Heights, IL 60463

Tax ID family

Bethshan Association4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Bethshan Association

  dba Bethshan Association II

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Palos Heights, IL
  • NPI 1164569281
  NPD tax ID
• Bethshan Association

  dba Tibstra House

  • Intellectual Disabilities Intermediate Care Facility
  • South Holland, IL
  • NPI 1689710121
  NPD tax ID
• Bethshan Association

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Palos Heights, IL
  • NPI 1790822815
  NPD tax ID

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471219200000",
    "number": "1952447443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12927 S MONITOR AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604632434",
            "telephone_number": "708-371-0800",
            "fax_number": "708-371-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12927 S MONITOR AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604632434",
            "telephone_number": "708-371-0800",
            "fax_number": "708-371-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHSHAN ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2016-08-15",
        "status": "A",
        "authorized_official_last_name": "GOUDZWAARD",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "708-371-0800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": "0027086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Best View LTD
• Beth Ledvora M.D. S.C.
• Bethany Christian Services
• Bethshan Association (Bethshan Association II)
• Bethshan Association
• Sheila Marie Bettinardi, SLP
• Michael Beyer, MD
• Beyond Healing
• Vasireddy Bhoopal, M.D.,
• Charlene Bielecki, ANP-BC

• Intellectual Disabilities Intermediate Care Facility in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Intellectual Disabilities Intermediate Care Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.