DASA MEDICAID PROVIDER
NPI 1922277631
Community/Behavioral Health in Dekalb, IL

Q: What is Ben Gordon Center's NPI number?

The NPI number for Ben Gordon Center is 1922277631. It was assigned to this organization in the NPPES registry on February 27, 2008. The provider is also known as Dasa Medicaid Provider.

Q: What is Ben Gordon Center's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Q: When was this NPI record last updated?

The NPPES record for Ben Gordon Center was last updated on April 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since February 27, 2008

12 HEALTH SERVICES DR, DEKALB, IL 60115(815) 756-4875(815) 756-2944 Get Directions Write a Review

NPPES record last updated: April 20, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dasa Medicaid Provider NPPES

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

DASA MEDICAID PROVIDER (NPI 1922277631) is a healthcare organization registered as a community/behavioral health in Dekalb, Illinois and active in the NPI registry since February 2008. The organization lists Michael Flora, Ceo/president, as its authorized official.

NPPES Registry Identity

NPI1922277631

Entity TypeOrganization

Primary Taxonomy251S00000X

Legal Business NameBEN GORDON CENTER

Location Address12 HEALTH SERVICES DRDekalb, IL 60115-9637

Mailing Address12 Health Services DrDekalb, IL 60115-9637 · (815) 756-4875 · Fax (815) 756-2944

Phone(815) 756-4875

Fax(815) 756-2944

Organization SubpartYes

Authorized OfficialMichael FloraCeo/president · (815) 756-4875

Enumeration DateFebruary 27, 2008

Last NPPES UpdateApril 20, 2008

✔ NPI 1922277631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies

Taxonomy Code251S00000X

License✔ Licensed in IL · A0254001A

Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

12 HEALTH SERVICES DR, Dekalb, IL 60115

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Other Names 1

Other NameDasa Medicaid Provider

Other Identifiers 1

Medicaid=========002IL

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER L WEBER LSW, CADC

Social Worker (Clinical)