CHURCH CREEK
NPI 1912962796
Assisted Living Facility in Arlington Heights, IL

NPI Status: Active since April 18, 2006

Contact Information

1200 W CENTRAL RD
ARLINGTON HEIGHTS, IL
ZIP 60005
Phone: (847) 506-3200
Fax: (847) 506-2598

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 14D0684494
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 10-01-2026

About CHURCH CREEK

This page provides the complete NPI Profile along with additional information for Church Creek, a provider established in Arlington Heights, Illinois operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1912962796 assigned on April 2006. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Church Creek. The authorized official of this NPI record is Jennifer F Mintzer (President & Chief Operating Officer)

NPI
1912962796
Provider Legal Name
SNH SE TENANT TRS, INC
Other Organization Name
CHURCH CREEK
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
1200 W CENTRAL RD ARLINGTON HEIGHTS, IL 60005
Location Phone
(847) 506-3200
Location Fax
(847) 506-2598
Mailing Address
255 WASHINGTON STREET 2 NEWTON PLACE NEWTON, MA 02458
Mailing Phone
(703) 854-0823
Mailing Fax
(847) 506-2598
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
04-18-2006
Last Update Date
10-11-2021
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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

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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)
1311500000XNursing & Custodial Care Facilities

Alzheimer Center (Dementia Center)

 
2314000000XNursing & Custodial Care Facilities

Skilled Nursing Facility

0043893 (IL)

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JENNIFER F MINTZER

Authorized Official Title
PRESIDENT & CHIEF OPERATING OFFICER
Authorized Official Phone
(617) 796-8350

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
14D0684494
Facility Type
Assisted Living Facility
Certificate Effective Date
October 02, 2024
Certificate Expiration Date
October 01, 2026
Laboratory Director
VALENTINE MBINGLO
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Church Creek 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 1912962796, we treat the final digit (6) 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 74. The final step is to find the difference between that total and the next multiple of ten (80 - 74 = 6).

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.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
1
Doubled → 2
Pos 4
2
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
6
Unchanged
Pos 7
2
Doubled → 4
Pos 8
7
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
6
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 1 → 2 9 → 18 → 9 2 → 4 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 2 + 2 + 1 + 8 + 6 + 4 + 7 + 1 + 8 + 24 = 74

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 74 is 80. The difference is the calculated check digit.

80 - 74 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1912962796.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Occupational Therapist
1200 W CENTRAL RD
ARLINGTON HEIGHTS, IL 60005
Occupational Therapist
1200 W CENTRAL RD
ARLINGTON HEIGHTS, IL 60005
Speech-Language Pathologist
1200 W CENTRAL RD
ARLINGTON HEIGHTS, IL 60005

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1912962796, enumerated as an "organization" on April 18, 2006.

The provider is located at 1200 W CENTRAL RD ARLINGTON HEIGHTS, IL 60005 and the phone number is (847) 506-3200.

Assisted Living Facility with taxonomy code 310400000X.