MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS (NPI# 1023263043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023263043 |
| Entity Type | Organization |
| Organization Name | MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS |
| Other Organization Name | MEMORIAL BEHAVIORAL HEALTH - SPRINGFIELD RESIDENTIAL CENTER (BLDG C) |
| Practice Address |
200 W Lake Dr Building C Springfield IL 62703-4956 |
| Mailing Address |
710 N 8th St Springfield IL 62702-6324 |
| Practice Telephone | 2175887932 |
| Practice Fax Number | 2175299803 |
| Mailing Telephone | 2175251064 |
| Mailing Fax Number | 2175251651 |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2016-03-17 |
| Authorized Official Name | ROBYN L LUKE (ADMINISTRATOR) |
| Authorized Official Telephone | 2175251064 |
| Is Organization Subpart | Y |
| Parent Organization Name | MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | IL | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Memorial Behavioral Health - Springfield Residential Center (Bldg C) | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730554692 | Mental Health Centers of Central Illinois | Day Training, Developmentally Disabled Services | 760 S Postville Dr, Lincoln, IL 62656-2237 | 2015-12-03 |
| 1558910794 | Mental Health Centers of Central Illinois | Clinic/Center | 303 E Bidwell St, Taylorville, IL 62568-1363 | 2019-09-10 |
| 1013401322 | Mental Health Centers of Central Illinois | Clinic/Center | 340 W State St, Jacksonville, IL 62650-2061 | 2018-06-20 |
| 1295160323 | Mental Health Centers of Central Illinois | Clinic/Center | 515 N College St, Lincoln, IL 62656-1401 | 2013-09-09 |
| 1225361769 | Mental Health Centers of Central Illinois | Clinic/Center | 200 W Lake Dr, Building A, Springfield, IL 62703-4956 | 2009-09-16 |
| 1750614798 | Mental Health Centers of Central Illinois | Counselor | 901 N 1st St, Suite 225, Springfield, IL 62702-3759 | 2009-09-09 |
| 1932354958 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building D, Springfield, IL 62703-4956 | 2008-11-18 |
| 1841445863 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building E, Springfield, IL 62703-4956 | 2008-11-18 |
| 1659525863 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Buidling B, Springfield, IL 62703-4956 | 2008-11-14 |
| 1457505125 | Mental Health Centers of Central Illinois | Clinic/Center | 5220 S 6th Street Rd, Suite 2400, Springfield, IL 62703-5735 | 2008-11-07 |
| Street Address |
200 W LAKE DR BUILDING C |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62703-4956 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114987690 | James L. Wilkerson | Counselor | 200 W Lake Dr, Springfield, IL 62703-4956 | 2006-03-27 |
| 1225361769 | Mental Health Centers of Central Illinois | Clinic/Center | 200 W Lake Dr, Building A, Springfield, IL 62703-4956 | 2009-09-16 |
| 1104071125 | West Lake Residential - Building 220 | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building 220, Springfield, IL 62703-4956 | 2008-11-18 |
| 1932354958 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building D, Springfield, IL 62703-4956 | 2008-11-18 |
| 1841445863 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building E, Springfield, IL 62703-4956 | 2008-11-18 |
| 1659525863 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Buidling B, Springfield, IL 62703-4956 | 2008-11-14 |
| 1346428786 | Cynthia S. Mester | Counselor | 200 W Lake Dr, Springfield, IL 62703-4956 | 2008-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790260917 | Jessica Lynne Zeeck | Behavior Technician | 5220 6th Street Frontage Road, E Suite 1700, Springfield, IL 62703 | 2018-10-03 |
| 1215415799 | Bree Schmulbach | Nurse Practitioner | Bsb Room 20, Springfield, IL 62703 | 2018-08-06 |
| 1144712100 | Fresenius Medical Care Springfield East, LLC | Clinic/Center | 140 S. Martin Luther King Jr. Drive, Springfield, IL 62703 | 2018-06-05 |
| 1558889170 | Ji Woung Choi | Dentist | 687 E Linton Ave., Springfield, IL 62703 | 2017-09-04 |
| 1477006161 | Encompass Home Health of The Midwest,llc | Home Health | 2970 Baker Dr, Springfield, IL 62703 | 2016-07-28 |
| 1851706824 | Terah Louise Holland | Obstetrics & Gynecology | 1100 E Lincolnshire Blvd Ste 200, Springfield, IL 62703 | 2014-06-27 |
| 1578993101 | Corey Moore | Behavioral Analyst | 5520 South 6th Street Road, Suite 1700, Springfield, IL 62703 | 2013-11-18 |
| 1134463052 | The Center for Youth and Family Solutions Inc. | Voluntary or Charitable | 614 North Sixth Street, Springfield, IL 62703 | 2012-11-15 |
| 1447519111 | Tenshi Furumi | Specialist/Technologist | One University Plaza, Univ. of Illinois-springfield, Ms Rec 2004, Springfield, IL 62703 | 2012-05-15 |
| 1447558390 | Shalini Mulkanoor | Family Medicine | 1100 E. Lincolnshire Blvd., Suite 200, Springfield, IL 62703 | 2011-03-02 |
| Find all providers in zip 62703 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679073712 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 622 57th St, Springfield, OR 97478-6821 | 2018-02-15 |
| 1912258443 | Elderhealth & Living | Community Based Residential Treatment Facility, Mental Illness | 382 S 58th St, Springfield, OR 97478-7623 | 2012-09-24 |
| 1457594731 | Gateway Assisted Living, Inc. | Community Based Residential Treatment Facility, Mental Illness | 620 N Cloverleaf Loop, Springfield, OR 97477-1167 | 2009-04-15 |
| 1225155898 | Department of Mental Health | Community Based Residential Treatment Facility, Mental Illness | Three Rivers Irtp, 26 Ridgewood Ter, Springfield, MA 01105-1315 | 2007-03-26 |
| 1255455374 | Volunteers of America of Georgia | Community Based Residential Treatment Facility, Mental Illness | 102 Deer Rd, Springfield, GA 31329-9201 | 2007-03-16 |
| 1629119086 | Rainrock Treatment Center, LLC | Community Based Residential Treatment Facility, Mental Illness | 41496 Mckenzie Hwy, Springfield, OR 97478-8688 | 2007-02-09 |
| 1619066313 | Project Woman | Community Based Residential Treatment Facility, Mental Illness | 1316 E High St, Springfield, OH 45505-1195 | 2006-10-12 |
| 1487040424 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 2211 Clear Vue Ln, Springfield, OR 97477-1373 | 2015-04-07 |
| 1225441256 | South Bay Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 140 High St, Springfield, MA 01199-1006 | 2014-06-06 |
| 1619308822 | Great Circle | Community Based Residential Treatment Facility, Mental Illness | 1212 W Lombard St, Springfield, MO 65806-2720 | 2013-12-13 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62703 |
Please comment or provide details below to improve the information on MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.