Provider Demographics
NPI:1225495823
Name:APOSTOLIC CHRISTIAN HOME FOR THE HANDICAPPED
Entity Type:Organization
Organization Name:APOSTOLIC CHRISTIAN HOME FOR THE HANDICAPPED
Other - Org Name:APOSTOLIC CHRISTIAN SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:MESSNER
Authorized Official - Suffix:
Authorized Official - Credentials:MCSW
Authorized Official - Phone:309-266-9781
Mailing Address - Street 1:2125 VETERANS RD
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:IL
Mailing Address - Zip Code:61550-9566
Mailing Address - Country:US
Mailing Address - Phone:309-266-9781
Mailing Address - Fax:309-266-9468
Practice Address - Street 1:2125 VETERANS RD
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:IL
Practice Address - Zip Code:61550-9566
Practice Address - Country:US
Practice Address - Phone:309-266-9781
Practice Address - Fax:309-266-9468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL91S090320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities