IT'S ABOUT CHANGE SOBER LIVING, INC. (NPI# 1790225050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790225050 |
| Entity Type | Organization |
| Organization Name | IT'S ABOUT CHANGE SOBER LIVING, INC. |
| Practice Address |
995 Bode Rd Elgin IL 60120-4523 |
| Mailing Address |
394 Madison Ave Calumet City IL 60409-2107 |
| Practice Telephone | 2242383279 |
| Practice Fax Number | 2242383279 |
| Mailing Telephone | 7088685014 |
| Mailing Fax Number | 7088688335 |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |
| Authorized Official Name | DR. ANTHONY DILLARD SR. (CEO) |
| Authorized Official Telephone | 7087725014 |
| Authorized Official Credential | NCRS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | A-8723-0002-A | IL | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | C/A-8723-0002-A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801336961 | It's About Change Sober Living, Inc. | Community/Behavioral Health | 1604 Horbor St., Calumet City, IL 60409 | 2017-03-08 |
| Street Address |
995 BODE RD |
| City | ELGIN |
| State | IL |
| Zip Code | 60120-4523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003356742 | Anthony Dillard Sr. | Counselor | 995 Bode Rd, Elgin, IL 60120-4523 | 2017-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003391749 | Kids Above All | Clinic/Center | United Methodist Church, 651 Lillie Street, Elgin, IL 60120 | 2018-09-28 |
| 1215483979 | Kelly Fetherling | Social Worker | 6912 S Main St., Elgin, IL 60120 | 2016-08-31 |
| 1164870457 | Peter Norton | Pharmacist | 1038 Summit Street, Elgin, IL 60120 | 2016-05-27 |
| 1417316373 | Beverly Brewster | Counselor | 675 Varsity Dr., Elgin, IL 60120 | 2016-02-19 |
| 1407194780 | Well Baby Care PC | Pediatrics | 1185-87 Dundee Avenue, Suite A-2, Elgin, IL 60120 | 2013-01-22 |
| 1740533546 | Vna Health Care | Clinic/Center | 801 Villa Street, Elgin, IL 60120 | 2012-10-18 |
| 1457638934 | Sharon Rose Nemenzo Araneta | Physical Therapist | 795 Summit St, Elgin, IL 60120 | 2011-11-10 |
| 1770866451 | Claudette M Vanhessen | Pharmacist | 815 Summit Street, Elgin, IL 60120 | 2011-09-20 |
| 1083993430 | Monica J. Fudala | Family Medicine | 820 Summit St # B4, Elgin, IL 60120 | 2011-08-16 |
| 1144517830 | Complete Care Medical Center, S.c | Family Medicine | 373 Summit St Ste 100, Elgin, IL 60120 | 2011-07-01 |
| Find all providers in zip 60120 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740743426 | Life Advocates LLC | Community/Behavioral Health | 525 Silver Spoon Ln, Elgin, SC 29045-7102 | 2019-04-10 |
| 1184183873 | Daystar Counseling & Consulting Services, LLC | Community/Behavioral Health | 7846 Us-277, Suite 3, Elgin, OK 73538 | 2019-03-13 |
| 1396168233 | Association for Individual Development | Community/Behavioral Health | 695 S State St, Elgin, IL 60123 | 2014-01-29 |
| 1710222823 | Youth Service Bureau of Illinois Valley | Community/Behavioral Health | 40 Du Page Ct Ste 400, Elgin, IL 60120-6418 | 2012-11-29 |
| 1477832244 | Summit Schools, Inc. | Community/Behavioral Health | 333 W River Rd, Elgin, IL 60123-1572 | 2011-08-11 |
| 1740507821 | Northwest Treatment Associates | Community/Behavioral Health | 1185 Dundee Ave Ste E1, Elgin, IL 60120-2233 | 2010-04-28 |
| 1811190564 | Kairos Family Center, Inc. | Community/Behavioral Health | 240 Standish St, Elgin, IL 60123-6421 | 2007-06-08 |
| 1346736204 | Phoenix Family Center, LLC | Community/Behavioral Health | 474 Summit St, Elgin, IL 60120-3829 | 2018-07-03 |
| 1730629924 | Association for Individual Development | Community/Behavioral Health | 120 S State St, Elgin, IL 60123-6403 | 2017-03-07 |
| 1639614175 | Mathers Recovery LLC | Community/Behavioral Health | 585 Tollgate Rd, Elgin, IL 60123-9323 | 2016-12-19 |
| Find all providers in ELGIN | ||||
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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.