Organization · Type 2 NPI
Good Shepherd Manor Groups Homes, Inc
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Momence, IL
Practice location
4129 N State Routes 1 & 17
Momence, IL 60954
Fax (815) 472-6086
Mailing address
PO Box 260, 4129 N State Routes 1 & 17
Momence, IL 60954-0260
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 0041913 (IL) |
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 41905 (IL) |
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | 96S015 (IL) |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
Another provider at this address
About NPI 1689998700
Good Shepherd Manor Groups Homes, Inc's National Provider Identifier is 1689998700, issued on Mar 18, 2010. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Momence, IL. The record was last updated on Mar 18, 2010.