FOURTY FOURTH STREET PLACE
NPI 1902936420
Intermediate Care Facility, Intellectual Disabilities in Decatur, IL

Active since March 06, 2007
1479 S 44TH ST, DECATUR, IL 62521(217) 422-2773 Get Directions Write a Review

NPPES record last updated: January 23, 2017. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Fourty Fourth Street Place NPPES

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

FOURTY FOURTH STREET PLACE (NPI 1902936420) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Decatur, Illinois and active in the NPI registry since March 2007. The organization lists David Michael Jacobus, President, as its authorized official.

NPPES Registry Identity

NPI1902936420
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameAUTUMN LEAVES, INC.
Location Address1479 S 44TH STDecatur, IL 62521-4323
Mailing Address1479 S 44th StDecatur, IL 62521-4323 · (217) 422-2773
Organization SubpartYesParent: Autumn Leaves. Inc
Authorized OfficialDavid Michael JacobusPresident · (217) 763-2191
Enumeration DateMarch 6, 2007
Last NPPES UpdateJanuary 23, 2017
NPI 1902936420 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 · 38737
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
1479 S 44TH ST, Decatur, IL 62521

Other Names 1

Doing Business AsFourty Fourth Street Place

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 Autumn Leaves, Inc.'s NPI number?

The NPI number for Autumn Leaves, Inc. is 1902936420. It was assigned to this organization in the NPPES registry on March 6, 2007. The provider is doing business as Fourty Fourth Street Place.

Where is Autumn Leaves, Inc. located?

Autumn Leaves, Inc. is located at 1479 S 44th St, Decatur, IL 62521. The listed phone number is (217) 422-2773.

What is Autumn Leaves, 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 Autumn Leaves, Inc. was last updated on January 23, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.