Provider Demographics
NPI:1245949841
Name:BAPT HOLDINGS
Entity type:Organization
Organization Name:BAPT HOLDINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHEYENNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SALTSGAVER
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:217-679-3156
Mailing Address - Street 1:2201 W WHITE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-6498
Mailing Address - Country:US
Mailing Address - Phone:217-679-3156
Mailing Address - Fax:
Practice Address - Street 1:2201 W WHITE OAKS DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-6498
Practice Address - Country:US
Practice Address - Phone:217-679-3156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-22
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL05Medicaid