LASHAE CAMPBELL


Address: 3 Wildwood Lane G, Bolingbrook, IL 60440-1942
Phone: 7089161128

LASHAE CAMPBELL (NPI# 1629531561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629531561
Entity Type Individual
Full Name LASHAE CAMPBELL
Practice Address 3 Wildwood Lane G
Bolingbrook
IL 60440-1942
Practice Telephone 7089161128
Mailing Telephone 7089161128
Enumeration Date 2019-04-08
Last Update Date 2019-04-08
Gender Code F
Is Sole Proprietor Y

Taxonomy

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

Office Location

Street Address 3 WILDWOOD LANE G
City BOLINGBROOK
State IL
Zip Code 60440-1942

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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

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]

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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
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Competitor

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City BOLINGBROOK
Zip Code 60440

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Dataset Information

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.

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