GRAND PRAIRIE SERVICES (NPI# 1417132093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417132093 |
| Entity Type | Organization |
| Organization Name | GRAND PRAIRIE SERVICES |
| Practice Address |
73 Westwood Dr Park Forest IL 60466-1414 |
| Mailing Address |
17746 Oak Park Ave Tinley Park IL 60477-3936 |
| Practice Telephone | 7084441012 |
| Mailing Telephone | 7084441012 |
| Mailing Fax Number | 7086149449 |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2016-05-12 |
| Authorized Official Name | SHARRONNE WARD (PRESIDENT & CEO) |
| Authorized Official Telephone | 7084441012 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154896371 | Grand Prairie Services | Clinic/Center | 747 Red Oak Ln, University Park, IL 60484-2965 | 2018-10-04 |
| 1053897736 | Grand Prairie Services | Clinic/Center | 759 Burr Oak Ln, University Park, IL 60484-2865 | 2018-07-16 |
| 1932526548 | Grand Prairie Services | Clinic/Center | 404 Sandburg St, Park Forest, IL 60466-1106 | 2014-03-20 |
| 1730363458 | Grand Prairie Services | Clinic/Center | 17850 Baker Ave, Country Club Hills, IL 60478-4729 | 2007-12-18 |
| 1093870602 | Grand Prairie Services | Clinic/Center | 136 - 142 1 2 S. Clinton, Bradley, IL 60915 | 2006-12-26 |
| 1063576502 | Grand Prairie Services | Clinic/Center | 67 E 34th St, Steger, IL 60475-1106 | 2006-12-20 |
| 1578627014 | Grand Prairie Services | Clinic/Center | 202 Westwood Dr, Park Forest, IL 60466-1617 | 2006-12-20 |
| 1770647059 | Grand Prairie Services | Clinic/Center | 561 Saratoga Dr, Chicago Heights, IL 60411-1914 | 2006-12-20 |
| 1598829020 | Grand Prairie Services | Clinic/Center | 854 Burnham Ave, Calumet City, IL 60409-4539 | 2006-12-20 |
| 1093879371 | Grand Prairie Services | Clinic/Center | 1236 Ashland Ave, Chicago Heights, IL 60411-2544 | 2006-12-20 |
| Street Address |
73 WESTWOOD DR |
| City | PARK FOREST |
| State | IL |
| Zip Code | 60466-1414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245741255 | Ariana Brown | Case Manager/Care Coordinator | 73 Westwood Dr, Park Forest, IL 60466-1414 | 2017-10-17 |
| 1487173191 | Darlene Jefferson | Case Manager/Care Coordinator | 73 Westwood Dr, Park Forest, IL 60466-1414 | 2017-09-13 |
| 1184147316 | Demitris Johnson | Case Manager/Care Coordinator | 73 Westwood Dr, Park Forest, IL 60466-1414 | 2017-07-19 |
| 1861928483 | Tracy Townes | Behavioral Analyst | 73 Westwood Dr, Park Forest, IL 60466-1414 | 2017-05-02 |
| 1710439971 | Davie Moore | Behavioral Analyst | 73 Westwood Dr, Park Forest, IL 60466-1414 | 2016-11-03 |
| 1518348234 | Brittany Davis | Behavioral Analyst | 73 Westwood Dr, Park Forest, IL 60466-1414 | 2015-06-18 |
| 1427440817 | Tenisha Oliver | Counselor | 73 Westwood Dr, Park Forest, IL 60466-1414 | 2015-02-23 |
| 1376947614 | Frankie Johnson | Behavioral Analyst | 73 Westwood Dr, Park Forest, IL 60466-1414 | 2014-10-15 |
| 1124422472 | Sandra Brooks | Behavioral Analyst | 73 Westwood Dr, Park Forest, IL 60466-1414 | 2014-10-15 |
| 1750785093 | Esther Fulcher | Behavioral Analyst | 73 Westwood Dr, Park Forest, IL 60466-1414 | 2014-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003464926 | Elda Jean Davis | Technician | 208 Juniper St, Park Forest, IL 60466 | 2019-09-04 |
| 1558806224 | Cindy Okolo | Nurse Practitioner | 111 E Sycamore Drive Suite 303, Park Forest, IL 60466 | 2017-01-04 |
| 1063891984 | April Washington | Occupational Therapist | 2 Lakewood Ct, Park Forest, IL 60466 | 2015-05-26 |
| 1093940363 | Andrene Renee Johnson | Durable Medical Equipment & Medical Supplies | 3224 S Western Ave, Park Forest, IL 60466 | 2009-05-15 |
| 1316181597 | Aunt Martha's Youth Service Center, Inc | Community Based Residential Treatment Facility, Mental Illness | 101 Wolpers Rd, Park Forest, IL 60466 | 2009-05-01 |
| 1255504155 | Joyce N Onyenso | Registered Nurse | 1037 Monterey Ct, University Park, IL 60466 | 2008-04-11 |
| 1891812327 | Comgraph Inc. | Clinic/Center | 252 Main Street, Park Forest, IL 60466 | 2007-03-22 |
| 1992800890 | Village of Park Forest | Home Health | 350 Victory Drive, Lower Level, Park Forest, IL 60466 | 2006-09-14 |
| 1366468324 | Reliable Healthcare Service LLC | Registered Nurse | 220 Forest Blvd, Park Forest Blvd, IL 60466 | 2006-07-14 |
| 1881257806 | Healing Steps Counseling, PC | Clinic/Center | 230 Main St, Park Forest, IL 60466 | 2019-04-16 |
| Find all providers in zip 60466 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578627014 | Grand Prairie Services | Clinic/Center | 202 Westwood Dr, Park Forest, IL 60466-1617 | 2006-12-20 |
| 1881257806 | Healing Steps Counseling, PC | Clinic/Center | 230 Main St, Park Forest, IL 60466 | 2019-04-16 |
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|---|---|---|---|---|
| 1225639990 | Mindy Forman, Psyd, LLC | Clinic/Center | 1020 Milwaukee Ave Ste 110, Deerfield, IL 60015-3555 | 2020-11-07 |
| 1346840295 | Stopka Professional Counseling LLC | Clinic/Center | 13125 Steeplechase Dr, New Lenox, IL 60451-1320 | 2020-10-29 |
| 1346848785 | Wellness Hearted Therapy LLC | Clinic/Center | 2675 S Cedar Glen Dr, Arlington Heights, IL 60005-5303 | 2020-10-16 |
| 1457959256 | Association for Individual Development | Clinic/Center | 708 N Bridge St, Yorkville, IL 60560-1105 | 2020-10-14 |
| 1285231555 | Association for Individual Development | Clinic/Center | 236 W Crystal Lake Ave, Crystal Lake, IL 60014-5847 | 2020-10-08 |
| 1386241123 | Envision Unlimited | Clinic/Center | 1801 N Spaulding Ave, Chicago, IL 60647-4926 | 2020-10-05 |
| 1881291789 | Jessica Weisbach, LLC | Clinic/Center | 2257 N Kedzie Blvd Apt 3, Chicago, IL 60647-2561 | 2020-10-04 |
| 1619574803 | Envision Unlimited | Clinic/Center | 2124 W 82nd Pl, Chicago, IL 60620-5358 | 2020-10-01 |
| 1144827320 | Envision Unlimited | Clinic/Center | 4919 N Clark St, Chicago, IL 60640-3514 | 2020-10-01 |
| 1194322370 | Envision Unlimited | Clinic/Center | 4911 S Hoyne Ave, Chicago, IL 60609-4721 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
| City | PARK FOREST |
| Zip Code | 60466 |
Please comment or provide details below to improve the information on GRAND PRAIRIE SERVICES.
| 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.