TDL GROUP, INC. (NPI# 1790141794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790141794 |
Entity Type | Organization |
Organization Name | TDL GROUP, INC. |
Other Organization Name | MATRIX PLACE |
Practice Address |
867 County Road 2150 E Fairfield IL 62837-2824 |
Mailing Address |
Po Box 705 Mount Vernon IL 62864-0015 |
Practice Telephone | 6188424823 |
Mailing Telephone | 6182447701 |
Enumeration Date | 2016-01-06 |
Last Update Date | 2016-01-06 |
Authorized Official Name | TONYA LINDSEY (PRESIDENT) |
Authorized Official Telephone | 6182447701 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
Other Name | Type Code |
---|---|
Matrix Place | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265898266 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 102 S Douglas St, Mc Leansboro, IL 62859-1637 | 2016-01-06 |
1164888160 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 1406 W Delaware St, Fairfield, IL 62837-2336 | 2016-01-06 |
1437515434 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 206 N Washington St, Mc Leansboro, IL 62859-1049 | 2016-01-06 |
1255797254 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 9135 N Spring Garden Ln, Mount Vernon, IL 62864-6624 | 2016-01-06 |
1972902534 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 11917 E Diana Rd, Mount Vernon, IL 62864-8873 | 2014-08-20 |
1578962288 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 709 E Saint Charles Ave, Mc Leansboro, IL 62859-1450 | 2014-08-19 |
1124383153 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 16711 N Old Centralia Ln, Mount Vernon, IL 62864-7697 | 2012-07-05 |
1780947960 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 2625 Eastview Dr, Belleville, IL 62221-4211 | 2012-06-21 |
1023371218 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 5305 Richview Rd, Mount Vernon, IL 62864-9609 | 2012-06-21 |
1407119696 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 105 Kensington Heights Rd, Belleville, IL 62226-5030 | 2012-06-21 |
Street Address |
867 COUNTY ROAD 2150 E |
City | FAIRFIELD |
State | IL |
Zip Code | 62837-2824 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881294619 | Katelyn Atteberry | Pharmacist | 150 Commerce Drive, Fairfield, IL 62837 | 2020-10-30 |
1265894521 | Rebecca August | Social Worker | 506 Nw 9th St, Fairfield, IL 62837 | 2016-03-25 |
1063814259 | Kathie L Hill | Social Worker | 303 Nw 11th St., Fairfield Memorial Hospital, Fairfield, IL 62837 | 2014-09-19 |
1912206731 | Way-fair Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 305 Northwest 11th Street, Fairfield, IL 62837 | 2011-03-18 |
1063600773 | Alvin Ewing | Counselor | 407 N. Basin Road, Fairfield, IL 62837 | 2007-10-09 |
1417145129 | Gilbert Tennyson | Counselor | 407 North Basin Rd, Fairfield, IL 62837 | 2007-10-09 |
1972791689 | Clint Harvey | Counselor | 407 North Basin Road, Fairfield, IL 62837 | 2007-10-09 |
1770789778 | Fairfield Estates, LLC | Point of Service | 315 North Market Street, Fairfield, IL 62837 | 2007-06-26 |
1346382207 | Robert E Lowry | Counselor | 407 N Basin Rd., Fairfield, IL 62837 | 2007-02-13 |
1790840825 | Bradley D Kramer | Dentist | 301 Nw 11th Street, Suite 212, Fairfield, IL 62837 | 2006-12-27 |
Find all providers in zip 62837 |
Taxonomy Code | 315P00000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Intermediate Care Facility, Mentally Retarded |
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164888160 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 1406 W Delaware St, Fairfield, IL 62837-2336 | 2016-01-06 |
1083882658 | Crossroads Living Center, Inc. | Intermediate Care Facility, Mentally Retarded | 325 Honeysuckle Dr, Fairfield, CA 94533-1124 | 2008-02-15 |
1023206380 | Rescare Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 5099 Camelot Dr, Fairfield, OH 45014-7423 | 2007-10-11 |
1841342771 | Developmental Planning & Services Inc | Intermediate Care Facility, Mentally Retarded | Rr 3 Box 601, Fairfield, IL 62837-9565 | 2007-01-18 |
1821158981 | North Country Associates, Inc | Intermediate Care Facility, Mentally Retarded | 149 Route 201, Fairfield, ME 04937-3372 | 2006-12-11 |
1972670016 | Miller Holdings Takoda, Inc. | Intermediate Care Facility, Mentally Retarded | 350 Kolb Dr, Fairfield, OH 45014-5357 | 2006-11-30 |
1245303528 | Jjr Enterprises Inc | Intermediate Care Facility, Mentally Retarded | 813 W Center St, Fairfield, IL 62837-1403 | 2006-11-16 |
1356707350 | T | Intermediate Care Facility, Mentally Retarded | 813 W Center St, Fairfield, IL 62837-1403 | 2016-01-06 |
1033474051 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 813 W Center St, Fairfield, IL 62837-1403 | 2012-07-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871039669 | Mount St Joseph | Intermediate Care Facility, Mentally Retarded | 24955 N Us Highway 12, Lake Zurich, IL 60047-8919 | 2017-01-17 |
1447792221 | Shore Community Services, Inc. | Intermediate Care Facility, Mentally Retarded | 8350 Laramie Ave, Skokie, IL 60077-2461 | 2016-11-10 |
1770930968 | Community Support Systems | Intermediate Care Facility, Mentally Retarded | 2311 Veterans Drive, Effingham, IL 62401 | 2016-05-18 |
1265898266 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 102 S Douglas St, Mc Leansboro, IL 62859-1637 | 2016-01-06 |
1376909374 | Tdl Group, Inc | Intermediate Care Facility, Mentally Retarded | 416 Chula Vista Dr, Belleville, IL 62221-3160 | 2016-01-06 |
1437515434 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 206 N Washington St, Mc Leansboro, IL 62859-1049 | 2016-01-06 |
1790141885 | Tdl Group, Inc | Intermediate Care Facility, Mentally Retarded | 212 Turning Leaf Cir, Belleville, IL 62221-6747 | 2016-01-06 |
1255797254 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 9135 N Spring Garden Ln, Mount Vernon, IL 62864-6624 | 2016-01-06 |
1093110066 | Ottawa Friendship House Work Activity Center, Inc | Intermediate Care Facility, Mentally Retarded | 600 West 12th Street, Streator, IL 61364 | 2014-11-03 |
1972902534 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 11917 E Diana Rd, Mount Vernon, IL 62864-8873 | 2014-08-20 |
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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.