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O'FALLON SITE 014010
NPI 1326376591
Foster Care Agency in O Fallon, IL

Active since November 30, 2009
791 WALL ST, O FALLON, IL 62269(618) 628-9424(618) 628-9426 Get Directions Write a Review

NPPES record last updated: November 30, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About O'fallon Site 014010 NPPES

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

O'FALLON SITE 014010 (NPI 1326376591) is a healthcare organization registered as a foster care agency in O Fallon, Illinois and active in the NPI registry since November 2009. The organization lists Viviane Ngwa, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1326376591
Entity TypeOrganization
Primary Taxonomy253J00000X
Legal Business NameILLINOIS MENTOR
Location Address791 WALL STO Fallon, IL 62269-1959
Mailing Address791 Wall StO Fallon, IL 62269-1959 · (618) 628-9424 · Fax (618) 628-9426
Phone(618) 628-9424
Fax(618) 628-9426
Organization SubpartYes
Authorized OfficialViviane NgwaExecutive Director · (708) 679-9137
Enumeration DateNovember 30, 2009
✔ NPI 1326376591 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFoster Care AgencyAgencies
Taxonomy Code253J00000X
Definition
A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as 24-hour substitute care for children outside their own homes. Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes.
Also ListedCase ManagementTaxonomy 251B00000X
Also ListedResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesTaxonomy 320600000X
791 WALL ST, O Fallon, IL 62269
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Other Names 1

Doing Business AsO'fallon Site 014010

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHEL MORGAN LCSW
Social Worker (Clinical)
791 WALL ST
O FALLON, IL 62269
St. Clair County (283) 223-7997
LYNN SEWESTER UNDERWOOD MA, LCPC
Counselor (Professional)
791 WALL ST
O FALLON, IL 62269
St. Clair County (618) 514-1154
ALLISON N SMITH MSN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
791 WALL ST
O FALLON, IL 62269
St. Clair County (283) 223-7997

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 Illinois Mentor's NPI number?

The NPI number for Illinois Mentor is 1326376591. It was assigned to this organization in the NPPES registry on November 30, 2009. The provider is doing business as O'fallon Site 014010.

Where is Illinois Mentor located?

Illinois Mentor is located at 791 Wall St, O Fallon, IL 62269. The listed phone number is (618) 628-9424.

What is Illinois Mentor's specialty?

The primary specialty registered for this NPI is Foster Care Agency with taxonomy code 253J00000X.

When was this NPI record last updated?

The NPPES record for Illinois Mentor was last updated on November 30, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.