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Good Shepherd Manor Groups Homes, Inc
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Momence, Illinois
NPI 1689998700

Good Shepherd Manor Groups Homes, Inc is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Momence, IL. Good Shepherd Manor Groups Homes, Inc practices in Momence, IL. The NPI Number for Good Shepherd Manor Groups Homes, Inc is 1689998700 and holds a License No. 0041913 (Illinois).

The current practice location address for Good Shepherd Manor Groups Homes, Inc is 4129 N State Routes 1 & 17, Momence, IL and can be reached out via phone at 815-472-3700 and via fax at 815-472-6086.

Location: 4129 N State Routes 1 & 17, Momence, IL, 60954-0260
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1689998700
Provider Name
Good Shepherd Manor Groups Homes, Inc
Credential
Provider Entity Type
Organization
Address
4129 N State Routes 1 & 17, Momence, IL, 60954-0260
Phone Number
815-472-3700
Fax Number
815-472-6086
Provider Enumeration Date
03/18/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4129 N State Routes 1 & 17
City
Momence
State
Illinois
Zip
60954
Phone Number
815-472-3700
Fax Number
815-472-6086
person
Provider Business Mailing Address Details
Address
4129 N State Routes 1 & 17
City
Momence
State
Illinois
Zip
60954
Phone Number
815-472-3700
Fax Number
815-472-6086
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
41905 (Illinois)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
0041913 (Illinois)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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