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CLITNON MANOR LIVING CENTER
NPI 1639487408
Intermediate Care Facility, Intellectual Disabilities in New Baden, IL

Active since September 15, 2010
111 E ILLINOIS ST, NEW BADEN, IL 62265(618) 588-2066(618) 588-4673 Get Directions Write a Review

NPPES record last updated: September 15, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Clitnon Manor Living Center NPPES

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

CLITNON MANOR LIVING CENTER (NPI 1639487408) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in New Baden, Illinois and active in the NPI registry since September 2010. The organization lists Michael Albert Brave, Administrator, as its authorized official.

NPPES Registry Identity

NPI1639487408
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameSOUTHERN ILLINOIS LIVING CENTERS INC.
Location Address111 E ILLINOIS STNew Baden, IL 62265-1850
Mailing Address300 E Illinois StNew Baden, IL 62265-1822 · (618) 588-2066 · Fax (618) 588-4673
Phone(618) 588-2066
Fax(618) 588-4673
Organization SubpartNo
Authorized OfficialMichael Albert BraveAdministrator · (618) 588-2066
Enumeration DateSeptember 15, 2010
✔ NPI 1639487408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
License✔ Licensed in IL · 0033159
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
111 E ILLINOIS ST, New Baden, IL 62265
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Other Names 1

Doing Business AsClitnon Manor Living Center

Other Identifiers 1

Medicaid371224393003IL

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.

SOUTHERN ILLINOIS LIVING CENTERS INC.
Skilled Nursing Facility
111 E ILLINOIS ST
NEW BADEN, IL 62265
Clinton County (618) 588-4924
JESSA KATE SPRINGER
Physical Therapy Assistant
111 E ILLINOIS ST
NEW BADEN, IL 62265
Clinton County (618) 588-4924
HANNAH ISBELL PTA
Physical Therapy Assistant
111 E ILLINOIS ST
NEW BADEN, IL 62265
Clinton County (618) 588-4924
MEGAN DEERHAKE OTR/L
Occupational Therapist
111 E ILLINOIS ST
NEW BADEN, IL 62265
Clinton County (618) 795-6682
ZACHARY STEPHEN CARMICHAEL M.S. CF-SLP
Speech-Language Pathologist
111 E ILLINOIS ST
NEW BADEN, IL 62265
Clinton County (618) 588-4924
AMY BOECKMANN PTA
Physical Therapy Assistant
111 E ILLINOIS ST
NEW BADEN, IL 62265
Clinton County (618) 588-4924

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 Southern Illinois Living Centers Inc.'s NPI number?

The NPI number for Southern Illinois Living Centers Inc. is 1639487408. It was assigned to this organization in the NPPES registry on September 15, 2010. The provider is doing business as Clitnon Manor Living Center.

Where is Southern Illinois Living Centers Inc. located?

Southern Illinois Living Centers Inc. is located at 111 E Illinois St, New Baden, IL 62265. The listed phone number is (618) 588-2066.

What is Southern Illinois Living Centers Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Southern Illinois Living Centers Inc. was last updated on September 15, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.