SHORE COMMUNITY SERVICES, INC. (NPI# 1447792221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447792221 |
| Entity Type | Organization |
| Organization Name | SHORE COMMUNITY SERVICES, INC. |
| Practice Address |
8350 Laramie Ave Skokie IL 60077-2461 |
| Practice Telephone | 8479822030 |
| Practice Fax Number | 8479822039 |
| Mailing Telephone | 8479822030 |
| Mailing Fax Number | 8479822039 |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2016-11-10 |
| Authorized Official Name | MRS. INDIA ALEXIS EHIOBA (CEO) |
| Authorized Official Telephone | 8479822030 |
| Authorized Official Credential | MNA, CFRE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 0028720 | IL | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487251195 | Shore Community Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8221 Teal Dr Ste 422, Easton, MD 21601-7212 | 2020-10-06 |
| Street Address |
8350 LARAMIE AVE |
| City | SKOKIE |
| State | IL |
| Zip Code | 60077-2461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427551787 | Jean M Deering | Social Worker | 8350 Laramie Ave, Skokie, IL 60077-2461 | 2018-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740835347 | Tharani Theivakumar | Dentist | 5225 W. Touhy Ave, Skokie, IL 60077 | 2019-08-09 |
| 1780179838 | Total Renal Care Inc | Clinic/Center | 8950 Gross Point Rd Ste 300, Skokie, IL 60077 | 2018-06-29 |
| 1811481070 | Joseph Rubin | Counselor | 7929 Lincoln Ave Ste 202, Skokie, IL 60077 | 2018-06-20 |
| 1245721067 | Lipnick Orthopaedics S.c. | Orthopaedic Surgery | 4856 Oakton Street, Skokie, IL 60077 | 2018-05-29 |
| 1376034991 | Karen Bradley | Nurse Practitioner | 5143 Coyle Ave, Skokie, IL 60077 | 2018-05-21 |
| 1093217036 | Arnold Arellano | Pedorthist | 5202 Old Orchard Road, N100, Skokie, IL 60077 | 2018-03-06 |
| 1043722408 | Carolyn Mary Jarozewski I | Registered Nurse | 5250 N.old Orchard Road Suite 300, 5250 N.old Orchard Road Suite 300, Skokie, IL 60077 | 2017-10-25 |
| 1841718400 | Katie Kluga | Nurse Practitioner | 9977 Woods Drive Suite 300, Skokie, IL 60077 | 2017-09-05 |
| 1265950091 | Larry Asher Sidel | Counselor | 9530 Lamon Pl.apt 110, Skokie, IL 60077 | 2017-08-31 |
| 1578088639 | Eleni Toumplis | Pharmacist | 4955 Dempster St, Skokie, IL 60077 | 2017-08-10 |
| Find all providers in zip 60077 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871039669 | Mount St Joseph | Intermediate Care Facility, Mentally Retarded | 24955 N Us Highway 12, Lake Zurich, IL 60047-8919 | 2017-01-17 |
| 1770930968 | Community Support Systems | Intermediate Care Facility, Mentally Retarded | 2311 Veterans Drive, Effingham, IL 62401 | 2016-05-18 |
| 1265898266 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 102 S Douglas St, Mc Leansboro, IL 62859-1637 | 2016-01-06 |
| 1164888160 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 1406 W Delaware St, Fairfield, IL 62837-2336 | 2016-01-06 |
| 1376909374 | Tdl Group, Inc | Intermediate Care Facility, Mentally Retarded | 416 Chula Vista Dr, Belleville, IL 62221-3160 | 2016-01-06 |
| 1437515434 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 206 N Washington St, Mc Leansboro, IL 62859-1049 | 2016-01-06 |
| 1790141885 | Tdl Group, Inc | Intermediate Care Facility, Mentally Retarded | 212 Turning Leaf Cir, Belleville, IL 62221-6747 | 2016-01-06 |
| 1790141794 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 867 County Road 2150 E, Fairfield, IL 62837-2824 | 2016-01-06 |
| 1255797254 | Tdl Group, Inc. | Intermediate Care Facility, Mentally Retarded | 9135 N Spring Garden Ln, Mount Vernon, IL 62864-6624 | 2016-01-06 |
| 1093110066 | Ottawa Friendship House Work Activity Center, Inc | Intermediate Care Facility, Mentally Retarded | 600 West 12th Street, Streator, IL 61364 | 2014-11-03 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SHORE COMMUNITY SERVICES, INC..
| 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.