OrganizationActive
Southern Illinois Living Centers Inc.
NPI 1639487408 · Intellectual Disabilities Intermediate Care Facility · New Baden, IL
Provider details
- NPI number
- 1639487408
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Michael Brave, Administrator(618) 588-2066
- License
- 0033159 (IL)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(83/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
111 E Illinois St
New Baden, IL 62265-1850
Phone: (618) 588-2066
Fax: (618) 588-4673
Street-level locationGet directions
Mailing address
300 E Illinois St
New Baden, IL 62265-1822
Other names (DBA / former)
- Doing business as
- Clitnon Manor Living Center
Registry dates
- Enumerated
- 2010-09-15
- Last updated
- 2010-09-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.