BETHSHAN ASSOCIATION NPI 1952447443

NPI Information

NPI: 1952447443
Provider Name: BETHSHAN ASSOCIATION
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization

CLIA Number: 14D1036757

Address:
12927 S MONITOR AVE
PALOS HEIGHTS, IL
ZIP 60463
Phone: (708) 371-0800
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BETHSHAN ASSOCIATION is an intermediate care facility mentally retarded in Palos Heights, IL. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. BETHSHAN ASSOCIATION NPI is 1952447443. The provider is registered as an organization entity type.

The provider's business location address is:

12927 S MONITOR AVE
PALOS HEIGHTS, IL
ZIP 60463-434
Phone: (708) 371-0800
Fax: (708) 371-0833

The provider's authorized official is Steven J Goudzwaard .
The authorized official title is Director Of Finance and has the following contact phone number (708) 371-0800.

The CLIA number assigned to this NPI record is 14D1036757 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/30/2007 and was last updated on 8/15/2016.

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		0027086	ILLINOIS	Yes

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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