FAIR HAVENS CHRISTIAN HOME, INC. (NPI# 1528219938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528219938 |
| Entity Type | Organization |
| Organization Name | FAIR HAVENS CHRISTIAN HOME, INC. |
| Practice Address |
1790 S Fairview Ave Decatur IL 62521-4010 |
| Practice Telephone | 2174292551 |
| Practice Fax Number | 2174292942 |
| Mailing Telephone | 2174292551 |
| Mailing Fax Number | 2174292942 |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2013-12-11 |
| Authorized Official Name | MRS. SUSAN MCGHEE (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3145877903 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
0018143 | IL | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619276524 | Fair Havens Christian Home, Inc. | Skilled Nursing Facility | 565 W Marion Ave, Forsyth, IL 62535-2099 | 2011-03-17 |
| 1083630487 | Fair Havens Christian Home, Inc. | Skilled Nursing Facility | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2006-07-15 |
| 1710425509 | Fair Havens Christian Home, Inc. | Clinic/Center | 565 W Marion Ave, Forsyth, IL 62535-2099 | 2017-02-01 |
| Street Address |
1790 S FAIRVIEW AVE |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-4010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083630487 | Fair Havens Christian Home, Inc. | Skilled Nursing Facility | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2006-07-15 |
| 1720638521 | Fair Havens Senior Living LLC | Skilled Nursing Facility | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2019-09-13 |
| 1376806836 | Gregory Eugene Hamilton Jr. | Physical Therapist | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2012-06-20 |
| 1154637072 | Michael Warner | Occupational Therapy Assistant | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2010-08-30 |
| 1659520104 | Cathy J Solomon | Physical Therapist | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2008-09-09 |
| 1083862478 | Michelle Lynn Dehaai Fletcher | Occupational Therapy Assistant | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2008-08-28 |
| 1942458351 | Don Eugene Sprague | Physical Therapy Assistant | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2008-08-28 |
| 1396992723 | Kris Bernardin IIi | Occupational Therapy Assistant | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2008-08-27 |
| 1013164029 | Tracy Marie Daniels | Occupational Therapy Assistant | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2008-08-20 |
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|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 332BX2000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Oxygen Equipment & Supplies |
| Definition to come... |
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| 1669992665 | Easy Oxygen Inc. | Durable Medical Equipment & Medical Supplies | 1862 E Belvidere Road #125, Grayslake, IL 60030 | 2017-06-21 |
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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.