PERSHING TERRACE
NPI 1164694501
Intermediate Care Facility, Intellectual Disabilities in Wood River, IL
NPI Status: Active since March 26, 2008
Contact Information
460 PERSHING
WOOD RIVER, IL
ZIP 62095
Phone: (618) 258-1616
Fax: (618) 258-1641
- Organization
- Intermediate Care Facility, Intellectual...
About PERSHING TERRACE
This page provides the complete NPI Profile along with additional information for Pershing Terrace, a provider established in Wood River, Illinois operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1164694501 assigned on March 2008. The practitioner's primary taxonomy code is 315P00000X with license number 39703 (IL). The provider is registered as an organization and their NPI record was last updated 17 years ago. The provider's is doing business as Pershing Terrace. The authorized official of this NPI record is Mr. Ronald J Wilson (Authorized Agent)
- NPI
- 1164694501
- Provider Legal Name
- COMMUNITY LIVING OPTIONS INC
- Other Organization Name
- PERSHING TERRACE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 460 PERSHING WOOD RIVER, IL 62095
- Location Phone
- (618) 258-1616
- Location Fax
- (618) 258-1641
- Mailing Address
- 285 SOUTH FARNHAM STREET GALESBURG, IL 61401
- Mailing Phone
- (309) 343-1550
- Mailing Fax
- (618) 258-1641
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 03-26-2008
- Last Update Date
- 04-20-2008
- 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
Intermediate Care Facility, Intellectual Disabilities
- Taxonomy Code
- 315P00000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 39703
- License State
- IL
- Taxonomy Description
- An intermediate care facility providing services for individuals with intellectual disabilities.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| =========055 | MEDICAID (05) | IL |
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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 | 1 | 6 | 4 | 6 | 9 | 4 | 5 | 0 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 12 | 4 | 12 | 9 | 8 | 5 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 2 + 4 + 1 + 2 + 9 + 8 + 5 + 0 + 24 = 59 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 59 = 1 | 1 | ||||||||
The NPI number 1164694501 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1164694501, enumerated as an "organization" on March 26, 2008.
The provider is located at 460 PERSHING WOOD RIVER, IL 62095 and the phone number is (618) 258-1616.
Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
