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General NPI Number Information
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NPI Number | 1770884918
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Entity Type | Organization
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Legal Business Name | APOSTOLIC CHRISTIAN HOME FOR THE HANDICAPPED
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 1000 LINDEN ST
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City | MORTON
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State | IL
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Zip | 61550-9517
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Country | US
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Telephone | 309-266-9781
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Fax | 309-266-9468
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Provider Business Mailing Address
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Address Line | 1000 LINDEN ST
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City | MORTON
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State | IL
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Zip | 61550-9517
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Country | US
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Telephone | 309-266-9781
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Fax | 309-266-9468
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Authorized Official
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Title or Position | PRESIDENT OF THE BOARD
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Name | STAN VIRKLER
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Credential |
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Telephone | 309-266-9781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 0039305
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License Number State | IL
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