Provider Demographics
NPI:1821379421
Name:CHRISTIAN HOMES, INC.
Entity Type:Organization
Organization Name:CHRISTIAN HOMES, INC.
Other - Org Name:PLEASANT MEADOWS CHRISTIAN VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGHEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-587-7903
Mailing Address - Street 1:400 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHRISMAN
Mailing Address - State:IL
Mailing Address - Zip Code:61924-1042
Mailing Address - Country:US
Mailing Address - Phone:217-269-2396
Mailing Address - Fax:217-269-2603
Practice Address - Street 1:400 W WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:CHRISMAN
Practice Address - State:IL
Practice Address - Zip Code:61924-1042
Practice Address - Country:US
Practice Address - Phone:217-269-2396
Practice Address - Fax:217-269-2603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0019166343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========801Medicaid