SUPPORTING COMMUNITY INDEPENDENCE (NPI# 1023643772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023643772 |
| Entity Type | Organization |
| Organization Name | SUPPORTING COMMUNITY INDEPENDENCE |
| Practice Address |
1 Polo Grounds Ct Bethalto IL 62010-2623 |
| Practice Telephone | 6188064344 |
| Mailing Telephone | 6188064344 |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-03-03 |
| Authorized Official Name | MRS. ELIZABETH ANN SAHURI (CEO) |
| Authorized Official Telephone | 6188064344 |
| Authorized Official Credential | QIDP,RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
1 POLO GROUNDS CT |
| City | BETHALTO |
| State | IL |
| Zip Code | 62010-2623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558727990 | Mccormick Physical Therapy & Athletic Rehab | Physical Therapist | 131 Greenbrier Ln, Bethalto, IL 62010 | 2016-01-14 |
| 1063855310 | Hall Chiropractic LLC | Chiropractor | 106 Terrace St, Bethalto, IL 62010 | 2013-04-16 |
| 1538443502 | Rudy Mack | Pharmacist | 172 E Mcarthur Blvd, Bethalto, IL 62010 | 2011-10-07 |
| 1851308092 | Thomas Lawrence Kaltenbronn | Chiropractor | 164 E. Mcarthur, Bethalto, IL 62010 | 2006-08-01 |
| 1124515580 | Stephany Renee Luchtefeld | Nurse Practitioner | 159 E Mcarthur Dr, Bethalto, IL 62010 | 2018-04-20 |
| 1134636491 | Lynley E Atwood, LLC | Optometrist | 422 W Bethalto Dr, Bethalto, IL 62010 | 2018-01-08 |
| 1689101172 | Lindsey Nicole Naylor | Nurse Practitioner | 155 E Bethalto Dr, Bethalto, IL 62010 | 2017-05-16 |
| 1356624894 | Erin Michelle Austin | Pharmacist | 68 N Bellwood Rd, Bethalto, IL 62010 | 2011-09-21 |
| 1114170321 | Danielle Marie Atwood | Occupational Therapist | 1008 2nd St, Bethalto, IL 62010-1027 | 2008-10-31 |
| 1205053196 | Joseph B. Martin | Occupational Therapist | 335 Whispering Oaks Dr, Bethalto, IL 62010-1039 | 2007-04-20 |
| Find all providers in zip 62010 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548656788 | Residential Options, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 750 S Moreland Rd, Lot # 31, Bethalto, IL 62010-2172 | 2015-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275131419 | Foatex Health Cilacare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 823 163rd St, Calumet City, IL 60409-5915 | 2020-10-10 |
| 1053949404 | A Great Place To Stay LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 35580 N Knowles Rd, Lake Villa, IL 60046-9026 | 2020-03-31 |
| 1255966602 | Infinicare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1939 Waukegan Rd Ste 300, Glenview, IL 60025-1758 | 2020-03-05 |
| 1770116287 | Universal Homes LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12101 S La Salle St, Chicago, IL 60628-6618 | 2020-02-13 |
| 1760014625 | Tomeka R Morgan | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11543 S Ashland Ave, Chicago, IL 60643-5001 | 2020-02-10 |
| 1487292660 | Shalom Home Health Ltd | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8147 Seminole Ct, Orland Park, IL 60462-4919 | 2019-12-18 |
| 1447894613 | Compassionate Living Home Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2625 Butterfield Rd Ste 314e, Oak Brook, IL 60523-1234 | 2019-10-31 |
| 1417599945 | Miracle Comprehensive Serivces | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4440 Lincoln Hwy Ste 205, Matteson, IL 60443-3803 | 2019-10-16 |
| 1609435072 | Bliss Haven, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1304 Durham St, Johnston City, IL 62951-2043 | 2019-06-10 |
| 1629531561 | Lashae Campbell | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3 Wildwood Lane G, Bolingbrook, IL 60440-1942 | 2019-04-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.