MEMORIAL BEHAVIORAL HEALTH - SPRINGFIELD RESIDENTIAL CENTER (BLDG C)
NPI 1023263043
Community Based Residential Treatment Facility, Mental Illness in Springfield, IL
NPI Status: Active since November 18, 2008
Contact Information
200 W LAKE DR
BUILDING C
SPRINGFIELD, IL
ZIP 62703
Phone: (217) 588-7932
Fax: (217) 529-9803
- Organization
- Community Based Residential Treatment Fa...
- CLIA Number: 14D1102655
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-21-2025
About MEMORIAL BEHAVIORAL HEALTH - SPRINGFIELD RESIDENTIAL CENTER (BLDG C)
This page provides the complete NPI Profile along with additional information for Memorial Behavioral Health - Springfield Residential Center (bldg C), a provider established in Springfield, Illinois operating as a Community Based Residential Treatment Facility, Mental Illness. The healthcare provider is registered in the NPI registry with number 1023263043 assigned on November 2008. The practitioner's primary taxonomy code is 320800000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Memorial Behavioral Health - Springfield Residential Center (bldg C). The authorized official of this NPI record is Ann Bowling (Director)
- NPI
- 1023263043
- Provider Legal Name
- MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
- Other Organization Name
- MEMORIAL BEHAVIORAL HEALTH - SPRINGFIELD RESIDENTIAL CENTER (BLDG C)
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 200 W LAKE DR BUILDING C SPRINGFIELD, IL 62703
- Location Phone
- (217) 588-7932
- Location Fax
- (217) 529-9803
- Mailing Address
- 200 W LAKE DR BLDG C SPRINGFIELD, IL 62703
- Mailing Phone
- (217) 525-1064
- Mailing Fax
- (217) 529-9803
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 11-18-2008
- Last Update Date
- 10-31-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Community Based Residential Treatment Facility, Mental Illness
- Taxonomy Code
- 320800000X
- Type
- Residential Treatment Facilities
- License State
- IL
- Taxonomy Description
- A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D1102655
- Facility Type
- Physician Office
- Certificate Effective Date
- July 22, 2023
- Certificate Expiration Date
- July 21, 2025
- Laboratory Director
- LYDIA S. VILLAFUERTE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Memorial Behavioral Health - Springfield Residential Center (bldg C) to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for MEMORIAL BEHAVIORAL HEALTH - SPRINGFIELD RESIDENTIAL CENTER (BLDG C)
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 2 | 3 | 2 | 6 | 3 | 0 | 4 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 4 | 3 | 4 | 6 | 6 | 0 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 4 + 3 + 4 + 6 + 6 + 0 + 8 + 24 = 57 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 57 = 3 | 3 | ||||||||
The NPI number 1023263043 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 7 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1114987690 | JAMES L. WILKERSON LCPC Individual | Counselor (Mental Health) | 200 W LAKE DR SPRINGFIELD, IL 62703 (217) 529-9775 |
| 1346428786 | CYNTHIA S. MESTER PH.D. Individual | Counselor (Mental Health) | 200 W LAKE DR SPRINGFIELD, IL 62703 (217) 529-9775 |
| 1104071125 | WEST LAKE RESIDENTIAL - BUILDING 220 Organization | Community Based Residential Treatment Facility, Mental Illness | 200 W LAKE DR BUILDING 220 SPRINGFIELD, IL 62703 (217) 588-7934 |
| 1225361769 | MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS Organization | Community Based Residential Treatment Facility, Mental Illness | 200 W LAKE DR BUILDING A SPRINGFIELD, IL 62703 (217) 529-9775 |
| 1659525863 | MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS Organization | Community Based Residential Treatment Facility, Mental Illness | 200 W LAKE DR BUIDLING B SPRINGFIELD, IL 62703 (217) 588-7931 |
| 1841445863 | MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS Organization | Community Based Residential Treatment Facility, Mental Illness | 200 W LAKE DR BUILDING E SPRINGFIELD, IL 62703 (217) 588-7925 |
| 1932354958 | MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS Organization | Community Based Residential Treatment Facility, Mental Illness | 200 W LAKE DR BUILDING D SPRINGFIELD, IL 62703 (217) 588-7933 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1023263043, enumerated in the NPI registry as an "organization" on November 18, 2008
The provider is located at 200 W Lake Dr Building C Springfield, Il 62703 and the phone number is (217) 588-7932
This medical organization specializes in Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X
The provider's CLIA number is 14D1102655 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on November 18, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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