GOOD SHEPHERD MANOR, INC
NPI 1700100971
Day Training, Developmentally Disabled Services in Momence, IL
NPI Status: Active since March 17, 2010
Contact Information
4129 N STATE ROUTES 1 & 17
MOMENCE, IL
ZIP 60954
Phone: (815) 472-3700
Fax: (815) 472-6086
- Organization
- Day Training, Developmentally Disabled S...
- CLIA Number: 14D1055712
- CLIA Cert. Type: Intermediate Care Facility for Mentally Retarded
- CLIA Exp. Date: 06-22-2026
About GOOD SHEPHERD MANOR, INC
This page provides the complete NPI Profile along with additional information for Good Shepherd Manor, Inc, a provider established in Momence, Illinois operating as a Day Training, Developmentally Disabled Services. The healthcare provider is registered in the NPI registry with number 1700100971 assigned on March 2010. The practitioner's primary taxonomy code is 251C00000X with license number 6-374 (IL). The provider is registered as an organization and their NPI record was last updated 16 years ago. The authorized official of this NPI record is Mr. Bruce Robert Fitzpatrick (President)
- NPI
- 1700100971
- Provider Name
- GOOD SHEPHERD MANOR, INC
- Entity Type
- Organization
- Location Address
- 4129 N STATE ROUTES 1 & 17 MOMENCE, IL 60954
- Location Phone
- (815) 472-3700
- Location Fax
- (815) 472-6086
- Mailing Address
- PO BOX 260 4129 N STATE ROUTES 1 & 17 MOMENCE, IL 60954
- Mailing Phone
- (815) 472-3700
- Mailing Fax
- (815) 472-6086
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-17-2010
- Last Update Date
- 03-17-2010
- 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
Day Training, Developmentally Disabled Services
- Taxonomy Code
- 251C00000X
- Type
- Agencies
- License No.
- 6-374
- License State
- IL
- Taxonomy Description
- These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning.
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 | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | 0002865 (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
- 14D1055712
- Facility Type
- Intermediate Care Facility for Mentally Retarded
- Certificate Effective Date
- June 23, 2024
- Certificate Expiration Date
- June 22, 2026
- Laboratory Director
- BRUCE R. FITZPATRICK
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Good Shepherd Manor, Inc 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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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1700100971, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 49 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
MOMENCE, IL 60954
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1700100971, enumerated as an "organization" on March 17, 2010.
The provider is located at 4129 N STATE ROUTES 1 & 17 MOMENCE, IL 60954 and the phone number is (815) 472-3700.
Day Training, Developmentally Disabled Services with taxonomy code 251C00000X.
