OrganizationActive
Charleston Transitional Facility
NPI 1679667737 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Champaign, IL
Provider details
- NPI number
- 1679667737
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Dennis Carpenter, Cfo(217) 352-7158
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
1902 Fox Dr.
Suite B
Champaign, IL 61820-7158
Phone: (217) 352-7158
Fax: (217) 252-7166
Approximate (ZIP-level) locationGet directions
Mailing address
1902 Fox Dr.
Champaign, IL 61820-7158
Registry dates
- Enumerated
- 2006-10-03
- Last updated
- 2021-04-14
- Certified
- 2021-04-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.