LUTHERAN RETIREMENT CENTER ASSOCIATION (NPI# 1205279684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205279684 |
| Entity Type | Organization |
| Organization Name | LUTHERAN RETIREMENT CENTER ASSOCIATION |
| Other Organization Name | CONCORDIA VILLAGE OUTPATIENT THERAPY |
| Practice Address |
4101 W Iles Ave Springfield IL 62711-7051 |
| Practice Telephone | 2177939429 |
| Practice Fax Number | 2177931333 |
| Mailing Telephone | 2177939429 |
| Mailing Fax Number | 2177931333 |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2013-04-16 |
| Authorized Official Name | MR. MICHAEL RASO (REGIONAL VICE PRESIDENT) |
| Authorized Official Telephone | 3144462533 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Concordia Village Outpatient Therapy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225310246 | Lutheran Retirement Center Association | Skilled Nursing Facility | 4101 W Iles Ave, Springfield, IL 62711-7051 | 2011-09-15 |
| Street Address |
4101 W ILES AVE |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62711-7051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225310246 | Lutheran Retirement Center Association | Skilled Nursing Facility | 4101 W Iles Ave, Springfield, IL 62711-7051 | 2011-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578057220 | Merissa Pryor | Social Worker | 4200 Conestoga Drive, Mbn 120, Springfield, IL 62711 | 2018-06-17 |
| 1255884623 | Dental Professionals of Illinois, P.C. | Dentist | 2740 Prairie Crossing Drive, Springfield, IL 62711 | 2016-08-02 |
| 1841682424 | Americare At Centennial Pointe Assisted Living LLC | Assisted Living Facility | 3440 Hedley Road, Springfield, IL 62711 | 2015-02-19 |
| 1306249248 | Schon Dental, LLC | Dentist | 2809 Mansion Road Suite D, Springfield, IL 62711 | 2014-10-07 |
| 1891105490 | John Weiss | Pharmacist | 4200 Conestoga Drive, Springfield, IL 62711 | 2014-05-05 |
| 1720350689 | Victor Harold Lary | Family Medicine | 3251 Spaulding Orchard Road, Springfield, IL 62711 | 2012-02-07 |
| 1902181795 | Amanda Rose Davis | Pharmacist | 2500 Koke Mill Rd, Springfield, IL 62711 | 2011-10-12 |
| 1316233703 | Karen Zerkle | Dentist | 2809 Mansion Rd, Suite D, Springfield, IL 62711 | 2011-06-23 |
| 1255520557 | Link Chiropractic LLC | Chiropractor | 7012 Kingsmill Ct, Springfield, IL 62711 | 2007-10-23 |
| 1669688230 | Victoria Lynn Driskill | Dentist | 4701 W. Wabash Ave, Springfield, IL 62711 | 2007-05-14 |
| Find all providers in zip 62711 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
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| 1801104021 | Center for Human Development, Inc | Clinic/Center | 342 Birnie Ave, Springfield, MA 01107-1104 | 2010-09-22 |
| 1104099720 | Pioneer Chiropractic, Inc. | Clinic/Center | 250 Belmont Ave, Springfield, MA 01108-2024 | 2008-04-03 |
| 1154511624 | Virginia Pain & Rehabilitation Center, Pllc | Clinic/Center | 6620 Keene Dr, Springfield, VA 22152-2508 | 2007-07-30 |
| 1497956858 | Developmental Center of The Ozarks | Clinic/Center | 1545 E Pythian St, Springfield, MO 65802-2139 | 2007-05-31 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62711 |
Please comment or provide details below to improve the information on LUTHERAN RETIREMENT CENTER ASSOCIATION.
| 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.