PIONEER CENTER (NPI# 1902252075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902252075 |
| Entity Type | Organization |
| Organization Name | PIONEER CENTER |
| Practice Address |
310 Constitution Drive Sowth West Poplar Grove IL 61065 |
| Mailing Address |
310 Constitution Drive South West Poplar Grove IL 61065 |
| Practice Telephone | 8158001196 |
| Mailing Telephone | 8158001196 |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2016-05-09 |
| Authorized Official Name | SHAHALONIE HERMAN (QIDP SUPERVISOR) |
| Authorized Official Telephone | 8159041327 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619413853 | Pioneer Center | Community/Behavioral Health | 333 Tulsa Ave, Carpentersville, IL 60110-1554 | 2017-01-11 |
| Street Address |
310 CONSTITUTION DRIVE SOWTH WEST |
| City | POPLAR GROVE |
| State | IL |
| Zip Code | 61065 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992352819 | Amber Suarez-christensen | Occupational Therapist | 4950 Il-173, Poplar Grove, IL 61065 | 2019-08-26 |
| 1588227300 | Kimberly Jozwiak | Counselor | 4950 Rte. 173, Poplar Grove, IL 61065 | 2019-04-17 |
| 1568738821 | Ashley Lynn Moritz | Speech-Language Pathologist | 4950 Route 173, Poplar Grove, IL 61065 | 2012-03-30 |
| 1326202441 | Felker Pharmacy Inc | Pharmacy | 13521 Illinois Rt 76, Poplar Grove, IL 61065 | 2008-07-17 |
| 1295744183 | William M Bitsas | Family Medicine | 406 Maple Leaf Ln, Poplar Grove, IL 61065 | 2006-08-07 |
| 1790718104 | Troy Michael Doetch | Family Medicine | 1200 Candlewick Dr Nw, Poplar Grove, IL 61065 | 2006-07-09 |
| 1548667371 | Gemma Fletcher | Physical Therapist | 4950 Route 173, Poplar Grove, IL 61065 | 2014-11-21 |
| 1700207768 | Kathy Blackmer | Counselor | 13508 Julie Dr, Poplar Grove, IL 61065 | 2013-12-18 |
| 1598883670 | Jeffry Stephen Clow | Speech-Language Pathologist | 492 Prairie Knoll Dr, Poplar Grove, IL 61065-7817 | 2007-03-27 |
| 1316262926 | Poplar Grove Physical Therapy, Inc. | Clinic/Center | 13526 Julie Dr, Poplar Grove, IL 61065-7829 | 2010-04-07 |
| Find all providers in zip 61065 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275131419 | Foatex Health Cilacare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 823 163rd St, Calumet City, IL 60409-5915 | 2020-10-10 |
| 1053949404 | A Great Place To Stay LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 35580 N Knowles Rd, Lake Villa, IL 60046-9026 | 2020-03-31 |
| 1255966602 | Infinicare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1939 Waukegan Rd Ste 300, Glenview, IL 60025-1758 | 2020-03-05 |
| 1023643772 | Supporting Community Independence | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1 Polo Grounds Ct, Bethalto, IL 62010-2623 | 2020-03-03 |
| 1770116287 | Universal Homes LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12101 S La Salle St, Chicago, IL 60628-6618 | 2020-02-13 |
| 1760014625 | Tomeka R Morgan | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11543 S Ashland Ave, Chicago, IL 60643-5001 | 2020-02-10 |
| 1487292660 | Shalom Home Health Ltd | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8147 Seminole Ct, Orland Park, IL 60462-4919 | 2019-12-18 |
| 1447894613 | Compassionate Living Home Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2625 Butterfield Rd Ste 314e, Oak Brook, IL 60523-1234 | 2019-10-31 |
| 1417599945 | Miracle Comprehensive Serivces | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4440 Lincoln Hwy Ste 205, Matteson, IL 60443-3803 | 2019-10-16 |
| 1609435072 | Bliss Haven, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1304 Durham St, Johnston City, IL 62951-2043 | 2019-06-10 |
| Find all providers with the same taxonomy | ||||
| City | POPLAR GROVE |
| Zip Code | 61065 |
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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.