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CHADDOCK NPI 1093063208


NPI Information

NPI: 1093063208
Provider Name: CHADDOCK
Classification: Foster Care Agency - 253J00000X
Entity Type: Organization
Address:
921 N 24TH ST
QUINCY, IL
ZIP 62301
Phone: (217) 222-0034
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CHADDOCK is a foster care agency in Quincy, IL. The provider is a Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as 24-hour substitute care for children outside their own homes. Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes. CHADDOCK NPI is 1093063208. The provider is registered as an organization entity type.

The provider's business location address is:

921 N 24TH ST
QUINCY, IL
ZIP 62301-267
Phone: (217) 222-0034
Fax: (217) 222-0253

The provider's authorized official is Kristen Patton .
The authorized official title is Director Of Finance and has the following contact phone number (217) 592-0317.

The enumeration date for this NPI number is 8/17/2012 and was last updated on 9/25/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
2253J00000XFoster Care Agency004048-12ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1#3A00-IPI-019MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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