GOLFVIEW DEVELOPMENTAL CENTER INC. NPI 1679567226

NPI Information

NPI: 1679567226
Provider Name: GOLFVIEW DEVELOPMENTAL CENTER, INC.
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization

CLIA Number: 14D1032595

Address:
9555 GOLF RD
DES PLAINES, IL
ZIP 60016
Phone: (847) 827-6628
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GOLFVIEW DEVELOPMENTAL CENTER, INC. is an intermediate care facility mentally retarded in Des Plaines, IL. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. GOLFVIEW DEVELOPMENTAL CENTER, INC. NPI is 1679567226. The provider is registered as an organization entity type.

The provider's business location address is:

9555 GOLF RD
DES PLAINES, IL
ZIP 60016-519
Phone: (847) 827-6628
Fax: (847) 827-0948

The provider's authorized official is Anthony R Miner .
The authorized official title is President and has the following contact phone number (847) 827-6628.

The CLIA number assigned to this NPI record is 14D1032595 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/9/2005 and was last updated on 8/22/2020.

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	315P00000X	Intermediate Care Facility, Intellectual Disabilities		0042614	ILLINOIS	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	14G190	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

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