GOOD SHEPHERD MANOR GROUPS HOMES, INC – NPI #1689998700
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

GOOD SHEPHERD MANOR GROUPS HOMES, INC is a community based residential treatment facility located in MOMENCE, IL. NPPES has assigned the NPI number 1689998700 to GOOD SHEPHERD MANOR GROUPS HOMES, INC on March 18, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GOOD SHEPHERD MANOR GROUPS HOMES, INC below.

NPI Profile for
GOOD SHEPHERD MANOR GROUPS HOMES, INC

NPI Number
1689998700
Enumeration Date

(more than 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GOOD SHEPHERD MANOR GROUPS HOMES, INC
Primary location
4129 N STATE ROUTES 1 & 17
MOMENCE, IL 60954
Phone: (815) 472-3700 Fax: (815) 472-6086
Mailing address
PO BOX 260
4129 N STATE ROUTES 1 & 17
MOMENCE, IL 60954-0260
Phone: (815) 472-3700 Fax: (815) 472-6086
Organization Subpart
No
Authorized Official
BRUCE FITZPATRICK
PRESIDENT
Phone: (815) 472-3700
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)		 IL 96S015
315P00000X
- Intermediate Care Facility, Intellectual Disabilities		 IL 0041913

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.