COVENANT ENABLING RESIDENCES OF ILLINOIS (NPI# 1285188342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285188342 |
| Entity Type | Organization |
| Organization Name | COVENANT ENABLING RESIDENCES OF ILLINOIS |
| Other Organization Name | BJORKLUND HOUSE |
| Practice Address |
15841 Terrace Dr Oak Forest IL 60452-2911 |
| Practice Telephone | 7086872038 |
| Practice Fax Number | 7086872762 |
| Mailing Telephone | 7086872038 |
| Mailing Fax Number | 7086872762 |
| Enumeration Date | 2016-08-06 |
| Last Update Date | 2016-08-06 |
| Authorized Official Name | JULIE ANN SMITH (ADMINISTRATOR) |
| Authorized Official Telephone | 7086872038 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Bjorklund House | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659559292 | Covenant Enabling Residences of Illinois | Intermediate Care Facility, Mentally Retarded | 15841 Terrace Dr, Oak Forest, IL 60452-2911 | 2008-02-06 |
| Street Address |
15841 TERRACE DR |
| City | OAK FOREST |
| State | IL |
| Zip Code | 60452-2911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659559292 | Covenant Enabling Residences of Illinois | Intermediate Care Facility, Mentally Retarded | 15841 Terrace Dr, Oak Forest, IL 60452-2911 | 2008-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831713098 | Oak Family Dental | Dentist | 6056 W. 159th Ave., Oak Forest, IL 60452 | 2020-06-03 |
| 1457982340 | Cook County | Family Medicine | 15900 S. Cicero, Oak Forest, IL 60452 | 2020-01-29 |
| 1265942718 | Suzanne Ankarlo | Speech-Language Pathologist | 3545 West Victoria Drive, Oak Forest, IL 60452 | 2017-10-10 |
| 1154855112 | True Laboratories LLC | Clinical Medical Laboratory | 5320 159th St Ste 505, Oak Forest, IL 60452 | 2017-04-17 |
| 1902347297 | Mena Loka Sr. | Physical Therapy Assistant | 6404 Nature Dr, Oak Forest, IL 60452 | 2017-03-20 |
| 1447797097 | Angelique Mayes-lamon | Clinic/Center | 15900 S Cicero Avenue, Building E, Oak Forest, IL 60452 | 2017-01-20 |
| 1265980759 | Surinder Sharma I | Pharmacist | 15900 So Cicero Ave, 15900 So Cicero Ave Bldg F, Oak Forest, IL 60452 | 2016-09-14 |
| 1326596800 | Gervaise Hunter-morris | Pharmacist | 15900 S. Cicero Avenue, Oak Forest, IL 60452 | 2016-09-14 |
| 1538519111 | Aunt Martha's Youth Service Center, Inc. | Clinic/Center | 15350 Oak Park Ave., Oak Forest, IL 60452 | 2016-06-15 |
| 1760836720 | Thh Acquisition LLC I | Durable Medical Equipment & Medical Supplies | 4149 166th St, Oak Forest, IL 60452 | 2016-04-15 |
| Find all providers in zip 60452 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689218273 | Dymond Homes LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4223 S Prairie Ave, Chicago, IL 60653-3211 | 2019-11-06 |
| 1447782396 | Light of Hope | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 22858 Millard Ave, Richton Park, IL 60471-2531 | 2017-03-30 |
| 1760831945 | Nucare Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 18118 Orleans Dr, Hazel Crest, IL 60429-2242 | 2016-06-08 |
| 1649629346 | Catina Ballin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8808 Riley Road, Wonderlake, IL 60097 | 2016-06-03 |
| 1003262254 | Patterson House Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 717 E 1st South St, Carlinville, IL 62626-1922 | 2016-05-06 |
| 1235592288 | Ray Graham Association | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 901 Warrenville Rd, Suite 500, Lisle, IL 60532-4301 | 2016-03-29 |
| 1962867796 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1315 N Curran Rd, Mchenry, IL 60050-6520 | 2015-12-21 |
| 1942675228 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 N Hart St, Harvard, IL 60033-2227 | 2015-12-11 |
| 1518332881 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 851 W Main St, Cary, IL 60013-1920 | 2015-12-11 |
| 1083089361 | Pioneer Center for Human Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 455 Huntley Rd, Crystal Lake, IL 60014-5318 | 2015-12-11 |
| Find all providers with the same taxonomy | ||||
| City | OAK FOREST |
| Zip Code | 60452 |
Please comment or provide details below to improve the information on COVENANT ENABLING RESIDENCES OF ILLINOIS.
| 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.