COLES COUNTY MENTAL HEALTH ASSOCIATION INC. NPI 1164600979

NPI Information

NPI: 1164600979
Provider Name: COLES COUNTY MENTAL HEALTH ASSOCIATION, INC.

Other Name: COURTYARD SQUARE

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
415 18TH ST
CHARLESTON, IL
ZIP 61920
Phone: (217) 238-5700
Get Directions

COLES COUNTY MENTAL HEALTH ASSOCIATION, INC. is a community based residential treatment facility mental illness in Charleston, IL. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. COLES COUNTY MENTAL HEALTH ASSOCIATION, INC. NPI is 1164600979. The provider is registered as an organization entity type.
The provider Other Name Is Courtyard Square.

The provider's business location address is:

415 18TH ST
CHARLESTON, IL
ZIP 61920-399
Phone: (217) 238-5700
Fax: (217) 238-5767

The provider's authorized official is Angie Williams .
The authorized official title is Access Center Coordinator and has the following contact phone number (217) 238-5735.

The enumeration date for this NPI number is 2/4/2008 and was last updated on 4/20/2008.

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
1	320800000X	Community Based Residential Treatment Facility, Mental Illness				Yes

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	=========006	MEDICAID	ILLINOIS

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

NPI Synchronization or Removal

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