CHILDREN'S HOME ASSOCIATION OF ILLINOIS (NPI# 1134355092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134355092 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S HOME ASSOCIATION OF ILLINOIS |
| Practice Address |
613 E. Frye Peoria IL 61603 |
| Mailing Address |
2130 N. Knoxville Ave Peoria IL 61603 |
| Practice Telephone | 3096877102 |
| Mailing Telephone | 3096851047 |
| Mailing Fax Number | 3096877299 |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2009-06-05 |
| Authorized Official Name | PATRICK M. PHELAN (VICE PRESIDENT OF OPERATIONS) |
| Authorized Official Telephone | 3096877255 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251V00000X | Voluntary or Charitable | Agencies | ||
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689192486 | Children's Home Association of Illinois | Clinic/Center | 5401 N Knoxville Ave Ste 412a, Peoria, IL 61614-5021 | 2017-09-01 |
| 1225347388 | Children's Home Association of Illinois | Community Based Residential Treatment Facility, Mental Illness | 2130 N Knoxville Ave, Peoria, IL 61603-2460 | 2010-10-06 |
| 1477783488 | Children's Home Association of Illinois | Community Based Residential Treatment Facility, Mental Illness | 109 E Arcadia Ave, Peoria, IL 61603-2401 | 2009-07-24 |
| 1003046012 | Children's Home Association of Illinois | Community Based Residential Treatment Facility, Mental Illness | 901 E Nebraska Ave, Peoria, IL 61603-2623 | 2009-07-24 |
| 1174750293 | Children's Home Association of Illinois | Community Based Residential Treatment Facility, Mental Illness | 2019 N Bigelow St, Peoria, IL 61604-3505 | 2009-06-16 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| 1285880674 | Children's Home Association of Illinois | Residential Treatment Facility, Emotionally Disturbed Children | 404 Ne Madison Ave, Peoria, IL 61603-3720 | 2008-08-18 |
| 1730335126 | Children's Home Association of Illinois | Community Based Residential Treatment Facility, Mental Illness | 511 Ne Madison Ave, Peoria, IL 61603-3830 | 2008-08-18 |
| 1851557086 | Children's Home Association of Illinois | Residential Treatment Facility, Emotionally Disturbed Children | 7225 W Plank Rd, Peoria, IL 61604-5252 | 2008-08-07 |
| 1174583660 | Children's Home Association of Illinois | Community/Behavioral Health | 2130 North Knoxville Ave, Peoria, IL 61603 | 2006-03-27 |
| Street Address |
613 E. FRYE |
| City | PEORIA |
| State | IL |
| Zip Code | 61603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362980 | Courtney Klein | Nurse Practitioner | 1306 N. Berkley Ave, Peoria, IL 61603 | 2020-10-08 |
| 1114588217 | Kong Xing Wang | Dentist | 320 East Armstrong Ave, Peoria, IL 61603 | 2019-06-28 |
| 1073015319 | Sara Kristine Rosenbery | Nurse Practitioner | 515 Ne Glen Oak Ave Ste 202, Peoria, IL 61603 | 2018-03-02 |
| 1861860058 | Jennifer Michelle Kelsey | Clinical Nurse Specialist | 420 Ne Glen Oak Avenue, Suite 401, Peoria, IL 61603 | 2015-09-04 |
| 1467859793 | Bonnie Lansing | Counselor | 617 N Gendale Avenue, Behavioral Health Adult Program, Peoria, IL 61603 | 2014-12-02 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1992054829 | Justin S Ferragut | Radiology | 530 Northeast Glen Oak Avenue, Peoria, IL 61603 | 2012-09-06 |
| 1780952994 | Syed Muhammad Tayyab | Internal Medicine | 828 Ne Glen Oak Ave Apt No208a, Peoria, IL 61603 | 2011-12-02 |
| 1528389079 | St. Francis Medical Center | General Acute Care Hospital | 530 N E Glen Oak Ave, Peoria, IL 61603 | 2010-06-18 |
| 1780810648 | Children's Home Association of Illinois | Voluntary or Charitable | 400 E. Frye, Peoria, IL 61603 | 2009-06-05 |
| Find all providers in zip 61603 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790166072 | Home Away From Home Behavioral Health Residential Facility Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 9231 W Mountain View Rd, Peoria, AZ 85345-4306 | 2015-06-12 |
| 1629379359 | Peoria County Court Administration | Residential Treatment Facility, Emotionally Disturbed Children | 324 Main St Ste 215, Peoria, IL 61602-2334 | 2010-11-11 |
| 1841431632 | Humble House | Residential Treatment Facility, Emotionally Disturbed Children | 8572 W Palo Verde Ave, Peoria, AZ 85345-5354 | 2009-03-09 |
| 1891942785 | Catholic Charities of The Diocese of Peoria | Residential Treatment Facility, Emotionally Disturbed Children | 419 Ne Madison Ave, Peoria, IL 61603-3719 | 2008-08-21 |
| 1285880674 | Children's Home Association of Illinois | Residential Treatment Facility, Emotionally Disturbed Children | 404 Ne Madison Ave, Peoria, IL 61603-3720 | 2008-08-18 |
| 1851557086 | Children's Home Association of Illinois | Residential Treatment Facility, Emotionally Disturbed Children | 7225 W Plank Rd, Peoria, IL 61604-5252 | 2008-08-07 |
| 1114197969 | Grace of Serenity Living, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 8340 N 86th Ln, Peoria, AZ 85345-2553 | 2008-03-07 |
| 1578695482 | New Horizon Youth Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8731 N 83rd Dr, Peoria, AZ 85345-7941 | 2007-03-09 |
| 1861523961 | New Horizon Youth Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 6726 W Cholla St, Peoria, AZ 85345-5850 | 2007-03-08 |
| 1730676024 | Children's Home Association of Illinois | Residential Treatment Facility, Emotionally Disturbed Children | 7225 W Plank Rd, Peoria, IL 61604-5252 | 2018-04-23 |
| Find all providers in PEORIA | ||||
Please comment or provide details below to improve the information on CHILDREN'S HOME ASSOCIATION OF 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.