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BEVERLY FARM FOUNDATION
NPI 1093880700
Intermediate Care Facility, Intellectual Disabilities in Godfrey, IL

Active since November 21, 2006CLIA 14D0433511 · Waiver
224 BACHMAN LN, GODFREY, IL 62035(618) 466-0367(618) 466-3652 Get Directions Write a Review

NPPES record last updated: August 25, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Beverly Farm Foundation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEVERLY FARM FOUNDATION (NPI 1093880700) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Godfrey, Illinois and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Brenda Miller, Finance Director, as its authorized official.

NPPES Registry Identity

NPI1093880700
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameBEVERLY FARM FOUNDATION
Location Address224 BACHMAN LNGodfrey, IL 62035-2122
Mailing Address6301 Humbert RdGodfrey, IL 62035-2163 · (618) 466-0367 · Fax (618) 466-3652
Phone(618) 466-0367
Fax(618) 466-3652
Organization SubpartNo
Authorized OfficialBrenda MillerFinance Director · (618) 466-0367
Enumeration DateNovember 21, 2006
Last NPPES UpdateAugust 25, 2016
✔ NPI 1093880700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
License✔ Licensed in IL · 0036939
Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

224 BACHMAN LN, Godfrey, IL 62035
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Other Identifiers 1

Medicaid=========004IL

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0433511

Beverly Farm Foundation · Godfrey, IL
Active · expires Aug 31, 2026
CLIA Number14D0433511
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorSandra A. Chadduck
Laboratory Phone(618) 466-0367
Laboratory LocationBeverly Farm Foundation6301 Humbert Rd, Godfrey, IL 62035
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beverly Farm Foundation's NPI number?

The NPI number for Beverly Farm Foundation is 1093880700. It was assigned to this organization in the NPPES registry on November 21, 2006.

Where is Beverly Farm Foundation located?

Beverly Farm Foundation is located at 224 Bachman Ln, Godfrey, IL 62035. The listed phone number is (618) 466-0367.

What is Beverly Farm Foundation's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Does Beverly Farm Foundation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0433511) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Beverly Farm Foundation was last updated on August 25, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.