VINTAGE SUPPORT GROUP, INC. (NPI# 1518337245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518337245 |
| Entity Type | Organization |
| Organization Name | VINTAGE SUPPORT GROUP, INC. |
| Practice Address |
900 Royal Heights Rd Belleville IL 62226-5457 |
| Practice Telephone | 6182774100 |
| Mailing Telephone | 6182774100 |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |
| Authorized Official Name | DAVID JAQUES (PRESIDENT/CEO) |
| Authorized Official Telephone | 6162774100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| Street Address |
900 ROYAL HEIGHTS RD |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-5457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760711980 | Support Systems and Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 900 Royal Heights Rd, Belleville, IL 62226-5457 | 2009-12-17 |
| 1306459649 | Stephanie Miner | Case Manager/Care Coordinator | 900 Royal Heights Rd, Belleville, IL 62226-5457 | 2020-08-26 |
| 1427660869 | Kayla R Adams | Counselor | 900 Royal Heights Rd, Belleville, IL 62226-5457 | 2020-08-18 |
| 1336751775 | Lisa Nicole Wellerritter | Counselor | 900 Royal Heights Rd, Belleville, IL 62226-5457 | 2020-08-18 |
| 1154932366 | Marjorie Kaye Wilson | Counselor | 900 Royal Heights Rd, Belleville, IL 62226-5457 | 2020-08-11 |
| 1437629276 | Michele Renee Tennyson | Counselor | 900 Royal Heights Rd, Belleville, IL 62226-5457 | 2018-12-04 |
| 1609346253 | Alexis Lore Murphy-furlough | Counselor | 900 Royal Heights Rd, Belleville, IL 62226 | 2018-11-27 |
| 1467993154 | Hoyleton Youth and Family Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 900 Royal Heights Rd, Suite 3150, Belleville, IL 62226-5457 | 2017-03-14 |
| 1427426782 | Jonah Daniel Martin | Behavioral Analyst | 900 Royal Heights Rd, Belleville, IL 62226-5457 | 2015-09-03 |
| 1790189157 | Kristen Whiteford | Behavioral Analyst | 900 Royal Heights Rd, Belleville, IL 62226-5457 | 2014-10-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619515665 | People Overcoming With Everlasting Results, Inc. | Day Training, Developmentally Disabled Services | 6400 W Main St Ste 1f-3, Belleville, IL 62223-3806 | 2019-12-19 |
| 1134772262 | Four Corners Community Services | Day Training, Developmentally Disabled Services | 115 Rutgers St, Belleville, NJ 07109-2535 | 2019-07-17 |
| 1376685081 | St. Clair Associated Vocational Enterprises, Inc. | Day Training, Developmentally Disabled Services | 3001 Save Rd, Belleville, IL 62221-7018 | 2007-02-12 |
| 1104194851 | Cadets' Caare Corner, LLC | Day Training, Developmentally Disabled Services | 79 Preston St, Belleville, NJ 07109-2268 | 2011-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386132520 | It Takes A Community LLC | Day Training, Developmentally Disabled Services | 9046 S Justine St, Chicago, IL 60620 | 2018-04-24 |
| 1215424460 | Victor C. Neumann Association | Day Training, Developmentally Disabled Services | 4434 W Diversey Ave, Chicago, IL 60639-1939 | 2018-04-13 |
| 1194212399 | Victor C Neumann Association | Day Training, Developmentally Disabled Services | 4122 N Nashville Ave, Chicago, IL 60634-1429 | 2018-04-13 |
| 1952825770 | Help At Home, LLC | Day Training, Developmentally Disabled Services | 1 N State St Ste 800, Chicago, IL 60602-3312 | 2017-08-02 |
| 1316478878 | Kathryn Elaine Miller Rose | Day Training, Developmentally Disabled Services | 1207 Lakeside Ln, Mahomet, IL 61853-9767 | 2017-03-25 |
| 1063943645 | Lf Walls Corp | Day Training, Developmentally Disabled Services | 1404 Fox Hound Trl, Beecher, IL 60401-5106 | 2017-03-24 |
| 1285186254 | Dorr-wood Ltd | Day Training, Developmentally Disabled Services | 1001 Rail Dr, Woodstock, IL 60098-9411 | 2016-10-26 |
| 1558818930 | Autismchicago | Day Training, Developmentally Disabled Services | 8035 S Wabash Ave, Chicago, IL 60619-3516 | 2016-09-02 |
| 1518411594 | Transitions of Western Illinois | Day Training, Developmentally Disabled Services | 631 N 48th St, Quincy, IL 62305-7918 | 2016-08-08 |
| 1487107538 | Dewitt County Human Resource Center | Day Training, Developmentally Disabled Services | 10840 State Rte 10e, Clinton, IL 61727-8927 | 2016-07-25 |
| Find all providers with the same taxonomy | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
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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.