Spencer Terrace
Intermediate Care Facility, Intellectual Disabilities in Mount Carmel, IL. Organization (NPI-2).
NPI number1679779342
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1679779342
- Entity type
- Organization (NPI-2)
- Legal business name
- Spencer Terrace
- Organization subpart
- No
- Enumeration date
- Jun 21, 2007
- Last updated
- Aug 22, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 315P00000X | Intermediate Care Facility, Intellectual Disabilities | 3701224518001 | IL | Yes |
Practice location
137 South DrMount Carmel, IL 62863-2811
Phone 618-262-8909
Mailing address
137 South DrMount Carmel, IL 62863-2811
Authorized official
David M Roberts
President
6182628909
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