State Of Illinois

LBN: 0014 Elisabeth Ludeman Center
State Of Illinois is an health care organization with primary practice located at 114 N Orchard Dr , Park Forest IL 60466-1200. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. 0014 Elisabeth Ludeman Center can be contacted via phone (708) 283-3000, or through Decker, David I via phone (708) 283-3001.

Contact Information

Primary practice address
114 N Orchard Dr Park Forest IL 60466-1200
Phone: (708) 283-3000
Fax: (708) 283-3020
Website:
Map and Directions
Authorized official contact:
Name: Decker, David I
Phone: (708) 283-3001

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X Illinois

Profile Details

NPI number 1841320702
LBN Legal business name 0014 Elisabeth Ludeman Center
DBA Doing business as State Of Illinois
Authorized official Decker, David I
Entity Organization
Organization subpart 1 No
Enumeration date Mar 7th, 2007
Last updated Jun 13th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841320702 NPPES
Illinois MEDICAID 000950014000

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