EMERALD ESTADES
NPI 1548433154
Intermediate Care Facility, Intellectual Disabilities in Canton, IL
- Organization
- Intermediate Care Facility, Intellectual...
- CLIA Number: 14D1062956
- CLIA Cert. Type: Intermediate Care Facility for Mentally Retarded
- CLIA Exp. Date: 01-01-2027
About EMERALD ESTADES
This page provides the complete NPI Profile along with additional information for Emerald Estades, a provider established in Canton, Illinois operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1548433154 assigned on April 2008. The practitioner's primary taxonomy code is 315P00000X with license number 0039354 (IL). The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's is doing business as Emerald Estades. The authorized official of this NPI record is Ms. Marcia Rose Qmrp (Rsd)
- NPI
- 1548433154 Verify this NPI
- Provider Legal Name
- PATTERSON HOUSE, INC.
- Other Organization Name
- EMERALD ESTADES
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1577 E MYRTLE ST CANTON, IL 61520
- Location Phone
- (309) 647-6604
- Location Fax
- (309) 647-0440
- Mailing Address
- PO BOX 25527 DECATUR, IL 62525
- Mailing Phone
- (217) 422-6510
- Mailing Fax
- (217) 422-6819
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-04-2008
- Last Update Date
- 06-24-2008
- 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.
- 0039354
- License State
- IL
- Taxonomy Description
- An intermediate care facility providing services for individuals with intellectual disabilities.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | 0039354 (IL) |
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
- 14D1062956
- Facility Type
- Intermediate Care Facility for Mentally Retarded
- Certificate Effective Date
- January 02, 2025
- Certificate Expiration Date
- January 01, 2027
- Laboratory Director
- NICKI PALMER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Emerald Estades 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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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1548433154, enumerated as an "organization" on April 04, 2008.
The provider is located at 1577 E MYRTLE ST CANTON, IL 61520 and the phone number is (309) 647-6604.
Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.
