BETHSHAN ASSOCIATION
NPI 1790822815
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Palos Heights, IL

NPI Status: Active since January 30, 2007

Contact Information

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

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About BETHSHAN ASSOCIATION

This page provides the complete NPI Profile along with additional information for Bethshan Association, a provider established in Palos Heights, Illinois operating as a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The healthcare provider is registered in the NPI registry with number 1790822815 assigned on January 2007. The practitioner's primary taxonomy code is 320900000X with license number 91C024 (IL). The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Steven J Goudzwaard (Director Of Finance)

NPI
1790822815
Provider Name
BETHSHAN ASSOCIATION
Entity Type
Organization
Location Address
12927 S MONITOR AVE PALOS HEIGHTS, IL 60463
Location Phone
(708) 371-0800
Location Fax
(708) 371-0833
Mailing Address
12927 S MONITOR AVE PALOS HEIGHTS, IL 60463
Mailing Phone
(708) 371-0800
Mailing Fax
(708) 371-0833
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-30-2007
Last Update Date
08-22-2020
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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, Intellectual and/or Developmental Disabilities

Taxonomy Code
320900000X
Type
Residential Treatment Facilities
License No.
91C024
License State
IL
Taxonomy Description
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

STEVEN J GOUDZWAARD

Authorized Official Title
DIRECTOR OF FINANCE
Authorized Official Phone
(708) 371-0800

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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.
1790822815
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
27180162482
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 8 + 0 + 1 + 6 + 2 + 4 + 8 + 2 + 24 = 65
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 65 = 55

The NPI number 1790822815 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1952447443BETHSHAN ASSOCIATION
Organization
Intermediate Care Facility, Intellectual Disabilities12927 S MONITOR AVE
PALOS HEIGHTS, IL 60463
(708) 371-0800
1164569281BETHSHAN ASSOCIATION
Organization
Residential Treatment Facility, Intellectual and/or Developmental Disabilities12927 S MONITOR AVE
PALOS HEIGHTS, IL 60463
(708) 371-0800

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1790822815, enumerated in the NPI registry as an "organization" on January 30, 2007

The provider is located at 12927 S Monitor Ave Palos Heights, Il 60463 and the phone number is (708) 371-0800

This medical organization specializes in Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X

This NPI record was last updated on January 30, 2007. 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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