UNIT 4463 CYPRESS HALL LOWER (NPI# 1063544823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063544823 |
| Entity Type | Organization |
| Organization Name | UNIT 4463 CYPRESS HALL LOWER |
| Practice Address |
1000 N Main St Anna IL 62906-1652 |
| Practice Telephone | 6188335161 |
| Mailing Telephone | 6188335161 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BRUCE BROWN (REIMBURSEMENT OFFICER II) |
| Authorized Official Telephone | 6188335161 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 14G045 | 05 |
| Street Address |
1000 N MAIN ST |
| City | ANNA |
| State | IL |
| Zip Code | 62906-1652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184137234 | Taylor Bre-an Phillips | Licensed Practical Nurse | 1000 N Main St, Anna, IL 62906-1652 | 2017-11-12 |
| 1558873414 | Amy M Miller | Psychologist | 1000 N Main St, Anna, IL 62906-1652 | 2017-11-01 |
| 1861915761 | Krystin Angel Grant | Nurse's Aide | 1000 N Main St, Anna, IL 62906-1652 | 2017-07-23 |
| 1295107696 | Richard Lamb | Dentist | 1000 N Main St, Anna, IL 62906-1652 | 2015-10-24 |
| 1790923399 | Percy Chester Myers | Anesthesiology | 1000 N Main St, Anna, IL 62906-1652 | 2009-02-04 |
| 1396956645 | Vikas Arora | Psychiatry & Neurology | 1000 N Main St, Choate Mental Health Hospital and Dev Center, Anna, IL 62906-1652 | 2007-05-25 |
| 1306978127 | Unit 1072 Upper Treatment Complex | Psychiatric Hospital | 1000 N Main St, Anna, IL 62906-1652 | 2007-03-09 |
| 1437281292 | Unit 4466 Sycamore Hall Upper | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1000 N Main St, Anna, IL 62906-1652 | 2007-03-09 |
| 1104958966 | Unit 4464 Cypress Hall Upper | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1000 N Main St, Anna, IL 62906-1652 | 2007-03-09 |
| 1942332614 | Unit 1061 Lower Treatment Complex | Psychiatric Hospital | 1000 N Main St, Anna, IL 62906-1652 | 2007-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265711600 | Community Integrated Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 110 Jeni Lane, Anna, IL 62906 | 2011-08-16 |
| 1508153768 | Union County Counseling Services Inc | Clinic/Center | 202 South St, Anna, IL 62906 | 2011-07-07 |
| 1326335589 | Union County Counseling Services Inc | Clinic/Center | 302 South St, Anna, IL 62906 | 2011-07-07 |
| 1063709228 | Union County Counseling Services Inc | Community Based Residential Treatment Facility, Mental Illness | 311 W Vienna St, Anna, IL 62906 | 2011-07-07 |
| 1598920928 | Steven Wayne Vincent | Dentist | 131 West Vienna Street, Anna, IL 62906 | 2008-07-24 |
| 1427236900 | Cardinal House Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 200 Douglas Street, Anna, IL 62906 | 2008-02-06 |
| 1992913719 | High Chiropractic Center | Chiropractor | 35 Walton Lane, Anna, IL 62906 | 2007-05-18 |
| 1023235678 | Chuck C. Bugle | Psychologist | 311 W. Spring St., Anna, IL 62906 | 2007-04-18 |
| 1922194604 | Nancy Kay Webb | Physical Therapist | 515 E Vienna Street, Suite I, Anna, IL 62906 | 2006-10-04 |
| 1144242918 | William W Mings | Psychiatry & Neurology | 204 South St, Anna, IL 62906 | 2006-07-24 |
| Find all providers in zip 62906 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164646550 | Mulberry Manor, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 612 E Davie, Anna, IL 62906-0088 | 2007-04-13 |
| 1952524217 | Holly Hill | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 203 Lafayette St, Anna, IL 62906-1545 | 2007-04-11 |
| 1821211137 | New Way, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 80 Knupp School Ln, Anna, IL 62906-3448 | 2007-04-11 |
| 1437281292 | Unit 4466 Sycamore Hall Upper | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1000 N Main St, Anna, IL 62906-1652 | 2007-03-09 |
| 1104958966 | Unit 4464 Cypress Hall Upper | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1000 N Main St, Anna, IL 62906-1652 | 2007-03-09 |
| 1154453991 | Illinois Department of Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1000 N Main St, Anna, IL 62906-1652 | 2007-03-09 |
| 1043342892 | Unit 4462 Cedar Hall Upper | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1000 N Main St, Anna, IL 62906-1652 | 2007-03-09 |
| 1710019575 | Unit 4465 Sycamore Hall Lower | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1000 N Main St, Anna, IL 62906-1652 | 2007-03-09 |
| 1457483240 | Unit 4467 Cottage Complex | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1000 N Main St, Anna, IL 62906-1652 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689218273 | Dymond Homes LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4223 S Prairie Ave, Chicago, IL 60653-3211 | 2019-11-06 |
| 1447782396 | Light of Hope | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 22858 Millard Ave, Richton Park, IL 60471-2531 | 2017-03-30 |
| 1760831945 | Nucare Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 18118 Orleans Dr, Hazel Crest, IL 60429-2242 | 2016-06-08 |
| 1649629346 | Catina Ballin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8808 Riley Road, Wonderlake, IL 60097 | 2016-06-03 |
| 1003262254 | Patterson House Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 717 E 1st South St, Carlinville, IL 62626-1922 | 2016-05-06 |
| 1235592288 | Ray Graham Association | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 901 Warrenville Rd, Suite 500, Lisle, IL 60532-4301 | 2016-03-29 |
| 1962867796 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1315 N Curran Rd, Mchenry, IL 60050-6520 | 2015-12-21 |
| 1942675228 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 N Hart St, Harvard, IL 60033-2227 | 2015-12-11 |
| 1518332881 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 851 W Main St, Cary, IL 60013-1920 | 2015-12-11 |
| 1083089361 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 455 Huntley Rd, Crystal Lake, IL 60014-5318 | 2015-12-11 |
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| 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.