Piasa Manor

LBN: Piasa Manor
Piasa Manor is an health care organization with primary practice located at 110 N Alby Ct , Godfrey IL 62035-1963. 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. Piasa Manor can be contacted via phone (618) 466-9242, or through Dodd, Carol Ann via phone (618) 466-9242.

Contact Information

Primary practice address
110 N Alby Ct Godfrey IL 62035-1963
Phone: (618) 466-9242
Fax: (618) 466-9517
Website:
Map and Directions
Authorized official contact:
Name: Dodd, Carol Ann
Phone: (618) 466-9242

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X 0038422 Illinois

Profile Details

NPI number 1346369642
LBN Legal business name Piasa Manor
DBA Doing business as
Authorized official Dodd, Carol Ann
Entity Organization
Organization subpart 1 No
Enumeration date Mar 28th, 2007
Last updated Aug 4th, 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 1346369642 NPPES
Illinois MEDICAID 371272004

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