IT'S ABOUT CHANGE SOBER LIVING, INC. (NPI# 1801336961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1801336961 |
Entity Type | Organization |
Organization Name | IT'S ABOUT CHANGE SOBER LIVING, INC. |
Practice Address |
1604 Horbor St. Calumet City IL 60409 |
Mailing Address |
394 Madison Ave Calumet City IL 60409-2107 |
Practice Telephone | 7083603205 |
Practice Fax Number | 7088688335 |
Mailing Telephone | 7088685014 |
Mailing Fax Number | 7088688335 |
Enumeration Date | 2017-03-08 |
Last Update Date | 2017-03-08 |
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-8723-0003-A | IL | Agencies |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | C/A-8723-0003-A | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790225050 | It's About Change Sober Living, Inc. | Community/Behavioral Health | 995 Bode Rd, Elgin, IL 60120-4523 | 2017-03-06 |
Street Address |
1604 HORBOR ST. |
City | CALUMET CITY |
State | IL |
Zip Code | 60409 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689159832 | Victory Pharmacy of Decatur Inc | Pharmacy | 1837 River Oaks Rd, Calumet City, IL 60409 | 2018-10-03 |
1750832986 | Jeffrey Mcneil | Social Worker | 660 Memorial Dr., Calumet City, IL 60409 | 2016-10-24 |
1578855219 | Cherechi V Onyenso | Nurse Practitioner | 1473 Ring Ring Road, Great Heights Family Medicine, Calumet City, IL 60409 | 2011-05-13 |
1205097607 | Michael Peter Weisberg | Ophthalmology | 1700 East West Road, Calumet City, IL 60409 | 2008-06-19 |
1861694333 | County of Cook | Local Education Agency (LEA) | 1255 Superior Ave, Calumet City, IL 60409 | 2007-06-05 |
1689875585 | Calumet City School District #155 | Local Education Agency (LEA) | Memorial Dr and Superior, Calumet City, IL 60409 | 2007-05-29 |
1932224185 | Micah K Swansey Sr. | Psychologist | 593 Burnham Avenue, Calumet City, IL 60409 | 2007-03-20 |
1184768210 | Beverly Williamson | Optometrist | 200 River Oaks Drive, Calumet City, IL 60409 | 2007-02-20 |
1205978863 | Dillons Dental Services LLC | Dentist | 2000 E 159th St, Calumet City, IL 60409 | 2007-02-12 |
1811080716 | Manzoor Hussain Shah | Internal Medicine | 1479 Ring Rd, Calumet City, IL 60409 | 2006-10-02 |
Find all providers in zip 60409 |
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 |
---|---|---|---|---|
1679927586 | Cjl Counseling Services LLC | Community/Behavioral Health | 42 164th St, Calumet City, IL 60409-6008 | 2016-04-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144820648 | Community Wellness Group | Community/Behavioral Health | 635 Argyle Ave, Flossmoor, IL 60422-1201 | 2020-10-26 |
1437758711 | Gina Baldacci, Lcsw, LLC | Community/Behavioral Health | 231 Longridge Dr, Bloomingdale, IL 60108 | 2020-10-19 |
1790383610 | Joni Lamb Therapy, LLC | Community/Behavioral Health | 1555 Sherman Ave # 308, Evanston, IL 60201-4421 | 2020-10-13 |
1811594906 | Everyday Empowered Clinical Services, Ltd. | Community/Behavioral Health | 5117 Main St, Suite #7, Downers Grove, IL 60515 | 2020-10-02 |
1942817150 | Pacem Wellness, LLC | Community/Behavioral Health | 8 Eagle Ctr Ste 12, O Fallon, IL 62269-1947 | 2020-09-30 |
1831703271 | Boules Clinical Psychology Group | Community/Behavioral Health | 200 S Frontage Rd Ste 324, Burr Ridge, IL 60527-6953 | 2020-09-02 |
1336753896 | Counseling Kennedy Shenberg | Community/Behavioral Health | 5752 N Campbell Ave Apt 1, Chicago, IL 60659-5080 | 2020-09-02 |
1265045371 | Brightside Recovery | Community/Behavioral Health | 1667 Belvidere Rd, Belvidere, IL 61008-9306 | 2020-08-28 |
1902419021 | Brightside Recovery | Community/Behavioral Health | 8041 186th St Ste B, Tinley Park, IL 60487-9344 | 2020-08-28 |
1700498573 | Bobby E. Wright Comprehensive Behavioral Health Center, Inc. | Community/Behavioral Health | 5816 W Division St Fl 1, Chicago, IL 60651-1003 | 2020-08-21 |
Find all providers with the same taxonomy |
City | CALUMET CITY |
Zip Code | 60409 |
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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.