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IT'S ABOUT CHANGE SOBER LIVING INC. NPI 1790225050


NPI Information

NPI: 1790225050
Provider Name: IT'S ABOUT CHANGE SOBER LIVING, INC.
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
995 BODE RD
ELGIN, IL
ZIP 60120
Phone: (224) 238-3279
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IT'S ABOUT CHANGE SOBER LIVING, INC. is a community behavioral health in Elgin, IL. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, 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. IT'S ABOUT CHANGE SOBER LIVING, INC. NPI is 1790225050. The provider is registered as an organization entity type.

The provider's business location address is:

995 BODE RD
ELGIN, IL
ZIP 60120-523
Phone: (224) 238-3279
Fax: (224) 238-3279

The provider's authorized official is Anthony Dillard .
The authorized official title is Ceo and has the following contact phone number (708) 772-5014.

The enumeration date for this NPI number is 3/6/2017 and was last updated on 3/6/2017.


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
1251S00000XCommunity/Behavioral HealthA-8723-0002-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
1C/A-8723-0002-AMEDICAIDILLINOIS

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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