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BOURBONNAIS TERRACE
NPI 1326690066
Intermediate Care Facility, Mental Illness in Bourbonnais, IL

Active since July 12, 2019CLIA 14D0429358 · Waiver
133 MOHAWK DR, BOURBONNAIS, IL 60914(815) 937-4790(815) 937-0432 Get Directions Write a Review

NPPES record last updated: July 12, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bourbonnais Terrace NPPES

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

BOURBONNAIS TERRACE (NPI 1326690066) is a healthcare organization registered as an intermediate care facility, mental illness in Bourbonnais, Illinois and active in the NPI registry since July 2019. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Shaun Ahmad, Manager, as its authorized official.

NPPES Registry Identity

NPI1326690066
Entity TypeOrganization
Primary Taxonomy310500000X
Legal Business NameLAUREATE BOURBONNAIS OPERATIONS LLC
Location Address133 MOHAWK DRBourbonnais, IL 60914-1349
Mailing Address13024 Ballantyne Corporate Pl Ste 425Charlotte, NC 28277-4420 · (704) 426-8849
Phone(815) 937-4790
Fax(815) 937-0432
Organization SubpartNo
Authorized OfficialShaun AhmadManager · (704) 426-8849
Enumeration DateJuly 12, 2019
✔ NPI 1326690066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Mental IllnessNursing & Custodial Care Facilities
Taxonomy Code310500000X
Definition
A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness.
133 MOHAWK DR, Bourbonnais, IL 60914
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Other Names 1

Doing Business AsBourbonnais Terrace

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 14D0429358

Bourbonnais Terrace N H (dba) B T Bourbonnais Care LLC · Bourbonnais, IL
Active · expires Aug 31, 2026
CLIA Number14D0429358
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorTina Raper Rn
Laboratory Phone(815) 937-4790
Laboratory LocationBourbonnais Terrace N H (dba) B T Bourbonnais Care LLC133 Mohawk, Bourbonnais, IL 60914
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

MX BEHAVIORAL HEALTH SC
Psychiatry & Neurology (Psychiatry)
133 MOHAWK DR
BOURBONNAIS, IL 60914
Kankakee County (815) 937-4790
MORRIS I ESFORMES & ARNOLD GASSEL
Nursing Facility/Intermediate Care Facility
133 MOHAWK DR
BOURBONNAIS, IL 60914
Kankakee County (815) 937-4896
BT BOURBONNAIS CARE, LLC
Intermediate Care Facility, Mental Illness
133 MOHAWK DR
BOURBONNAIS, IL 60914
Kankakee County (815) 937-4790
OAK FOREST PSYCHOLOGICAL SERVICE, P.C.
Psychiatry & Neurology (Psychiatry)
133 MOHAWK DR
BOURBONNAIS, IL 60914
Kankakee County (815) 937-4790
BOURBONNAIS TERRACE OPERATOR LLC
Nursing Facility/Intermediate Care Facility
133 MOHAWK DR
BOURBONNAIS, IL 60914
Kankakee County (815) 937-4790
MS. ALISON MARGARET HASSELBRING C.O.T.A.
Occupational Therapy Assistant
133 MOHAWK DR
BOURBONNAIS, IL 60914
Kankakee County (815) 937-0432

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 Laureate Bourbonnais Operations LLC's NPI number?

The NPI number for Laureate Bourbonnais Operations LLC is 1326690066. It was assigned to this organization in the NPPES registry on July 12, 2019. The provider is doing business as Bourbonnais Terrace.

Where is Laureate Bourbonnais Operations LLC located?

Laureate Bourbonnais Operations LLC is located at 133 Mohawk Dr, Bourbonnais, IL 60914. The listed phone number is (815) 937-4790.

What is Laureate Bourbonnais Operations LLC's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Mental Illness with taxonomy code 310500000X.

Does Laureate Bourbonnais Operations LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0429358) 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 Laureate Bourbonnais Operations LLC was last updated on July 12, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.