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LEYDEN FAMILY SERVICE & MENTAL HEALTH CENTER NPI 1043304546


NPI Information

NPI: 1043304546
Provider Name: LEYDEN FAMILY SERVICE & MENTAL HEALTH CENTER

Doing Business As: THE SHARE PROGRAM

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
1776 MOON LAKE BLVD.
HOFFMAN ESTATES, IL
ZIP 60169
Phone: (847) 882-4181
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LEYDEN FAMILY SERVICE & MENTAL HEALTH CENTER is a substance abuse rehabilitation facility in Hoffman Estates, IL. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. LEYDEN FAMILY SERVICE & MENTAL HEALTH CENTER NPI is 1043304546. The provider is registered as an organization entity type.
The provider Is Doing Business As The Share Program.

The provider's business location address is:

1776 MOON LAKE BLVD.
HOFFMAN ESTATES, IL
ZIP 60169
Phone: (847) 882-4181
Fax: (847) 882-4299

The provider's authorized official is Bruce Sewick .
The authorized official title is Chief Executive Officer and has the following contact phone number (847) 451-0330.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderA-0352-0003-AILLINOISNo
2324500000XSubstance Abuse Rehabilitation FacilityA0352-0003-AILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17942353OTHERILLINOISAETNA ID
2293079OTHERILLINOISVALUE OPTION ID
350069OTHERILLINOISBLUE CROSS/BLUE SHIELD ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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