NPIMap

Organization Active NPI

Home and Environments for Living and Programs

Doing business as Lebanon Terrace

  • Intellectual Disabilities Intermediate Care Facility
  • Lebanon, IL
National Provider Identifier
1962658120
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
0038430 Issued in IL
Legal business name
HOME AND ENVIRONMENTS FOR LIVING AND PROGRAMS
Doing business as
Lebanon Terrace
Practice address
221 E 3Rd St
Lebanon, IL 62254-1668
Phone
(618) 537-4133
Fax
(618) 537-4156
NPI assigned
Aug 7, 2008
Last updated
Aug 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

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

Authorized official

Name
Ms. Catherine A Brookshire
Title
Administrator
Phone
(217) 529-9632

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 0038430 IL Primary

Addresses

Primary practice location

221 E 3Rd St
Lebanon, IL 62254-1668

Mailing address

40 Adloff LN Ste 5
Springfield, IL 62703-4496
Phone (217) 529-9632

Other names 1

  • Lebanon Terrace Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Adloff Place6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1218067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1962658120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 ADLOFF LN STE 5",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627034496",
            "telephone_number": "217-529-9632",
            "fax_number": "217-529-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E 3RD ST",
            "city": "LEBANON",
            "state": "IL",
            "postal_code": "622541668",
            "telephone_number": "618-537-4133",
            "fax_number": "618-537-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME AND ENVIRONMENTS FOR LIVING AND PROGRAMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-07",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "BROOKSHIRE",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "217-529-9632",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": "0038430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lebanon Terrace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; 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.