IT'S ABOUT CHANGE SOBER LIVING, INC.


Address: 1604 Horbor St., Calumet City, IL 60409
Phone: 7083603205

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 251S00000X Community/Behavioral Health A-8723-0003-A IL Agencies

Other Provider Identifier

State Issuer Identifier Type Code
IL C/A-8723-0003-A 05

Other Provider IDs and Locations

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

Office Location

Street Address 1604 HORBOR ST.
City CALUMET CITY
State IL
Zip Code 60409

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 251S00000X
Grouping Agencies
Classification Community/Behavioral Health

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1679927586 Cjl Counseling Services LLC Community/Behavioral Health 42 164th St, Calumet City, IL 60409-6008 2016-04-17

Providers in the same taxonomy and state

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
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Competitor

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City CALUMET CITY
Zip Code 60409

Improve Information

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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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