BETHSHAN ASSOCIATION II
NPI 1164569281
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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  • Organization
  • Residential Treatment Facility, Intellec...
  • CLIA Number: 14D1036757
  • CLIA Cert. Type: Other
  • CLIA Exp. Date: 02-08-2027

About BETHSHAN ASSOCIATION II

This page provides the complete NPI Profile along with additional information for Bethshan Association Ii, a provider established in Palos Heights, Illinois operating as a Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The healthcare provider is registered in the NPI registry with number 1164569281 assigned on January 2007. The practitioner's primary taxonomy code is 320600000X with license number 0030528 (IL). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Bethshan Association Ii. The authorized official of this NPI record is Mr. Steven J Goudzwaard (Director Of Finance)

NPI
1164569281
Provider Legal Name
BETHSHAN ASSOCIATION
Other Organization Name
BETHSHAN ASSOCIATION II
Other Name Type
Doing Business As (3)
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

Residential Treatment Facility, Intellectual and/or Developmental Disabilities

Taxonomy Code
320600000X
Type
Residential Treatment Facilities
License No.
0030528
License State
IL
Taxonomy Description
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

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

MR. STEVEN J GOUDZWAARD

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

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
14D1036757
Facility Type
Other
Certificate Effective Date
February 09, 2025
Certificate Expiration Date
February 08, 2027
Laboratory Director
CHRISTINE KONIOR RN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Bethshan Association Ii 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.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1164569281, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
4
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
6
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
2
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 5 → 10 → 1 9 → 18 → 9 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 2 + 4 + 1 + 0 + 6 + 1 + 8 + 2 + 1 + 6 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1164569281.

Other Providers at the Same Location


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

Intermediate Care Facility, Intellectual Disabilities
12927 S MONITOR AVE
PALOS HEIGHTS, IL 60463
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
12927 S MONITOR AVE
PALOS HEIGHTS, IL 60463

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164569281, enumerated 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.

Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.