AVENUES TO INDEPENDENCE NPI 1215250881

NPI Information

  • NPI: 1215250881
  • Provider Name: AVENUES TO INDEPENDENCE
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Organization
  • CLIA Number: 14D2203791
  • Address: 515 BUSSE HWY
    PARK RIDGE, IL
    ZIP 60068
  • Phone: (847) 292-0870

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NPI Details

AVENUES TO INDEPENDENCE is a community based residential treatment facility, intellectual and/or developmental disabilities in Park Ridge, IL. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. AVENUES TO INDEPENDENCE NPI is 1215250881. The provider is registered as an organization entity type.

The provider's business location address is:

515 BUSSE HWY
PARK RIDGE, IL
ZIP 60068-154
Phone: (847) 292-0870
Fax: (847) 292-0873

The provider's authorized official is Robert Okazaki .
The authorized official title is Ceo and has the following contact phone number (847) 292-0870.

The CLIA number assigned to this NPI record is 14D2203791 - other - group home intellect dis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/10/2010 and was last updated on 3/10/2010.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesILLINOISYes

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: 3/30/2025

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