MARYVILLE ACADEMY (NPI# 1508174749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508174749 |
Entity Type | Organization |
Organization Name | MARYVILLE ACADEMY |
Other Organization Name | MARYVILLE MADDEN SHELTER |
Practice Address |
1658 W Grand Ave Chicago IL 60622-6309 |
Mailing Address |
1150 N River Rd Des Plaines IL 60016-1214 |
Practice Telephone | 3124913500 |
Mailing Telephone | 8472941999 |
Mailing Fax Number | 8472942892 |
Enumeration Date | 2010-09-22 |
Last Update Date | 2012-01-24 |
Authorized Official Name | MR. NORMAN JOYCE (DIRECTOR OF FINANCIAL SERVICES) |
Authorized Official Telephone | 8472941944 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
Other Name | Type Code |
---|---|
Maryville Madden Shelter | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366957292 | Maryville Academy | Clinic/Center | 1510 N Claremont Ave, Chicago, IL 60622-1710 | 2017-12-14 |
1487072781 | Maryville Academy | Clinic/Center | 1455 E Golf Rd Ste 210, Des Plaines, IL 60016-1254 | 2014-04-03 |
1275771214 | Maryville Academy | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 951 W Bartlett Rd, Bartlett, IL 60103-4479 | 2009-01-29 |
1477700474 | Maryville Academy | Residential Treatment Facility, Emotionally Disturbed Children | 10102 Farm School Rd, Durand, IL 61024-9725 | 2008-08-20 |
1578720041 | Maryville Academy | Long Term Care Hospital | 4015 N Oak Park Ave Bldg B, Chicago, IL 60634-7197 | 2008-05-21 |
1578697835 | Maryville Academy | Community/Behavioral Health | 1150 N River Rd, Des Plaines, IL 60016-1214 | 2007-03-16 |
1306873419 | Maryville Academy | Psychiatric Residential Treatment Facility | 555 Wilson Lane, Maryville Scott Nolan Center, Des Plaines, IL 60016-4729 | 2006-06-26 |
1821504788 | Maryville Academy | Clinic/Center | 1510 N Claremont Ave, Chicago, IL 60622-1710 | 2017-12-14 |
1487189445 | Maryville Academy | Clinic/Center | 951 W Bartlett Rd, Bartlett, IL 60103-4479 | 2017-04-27 |
1003341058 | Maryville Academy | Clinic/Center | 1658 W Grand Ave, Chicago, IL 60622-6309 | 2017-04-27 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | MARYVILLE ACADEMY | 1150 N River Rd, Des Plaines, IL 60016-1214 |
Street Address |
1658 W GRAND AVE |
City | CHICAGO |
State | IL |
Zip Code | 60622-6309 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003341058 | Maryville Academy | Clinic/Center | 1658 W Grand Ave, Chicago, IL 60622-6309 | 2017-04-27 |
1902353782 | Maryville Academy | Clinic/Center | 1658 W Grand Ave, Chicago, IL 60622-6309 | 2016-09-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447880471 | Erikson Institute | Clinic/Center | 2739 W Division St, Chicago, IL 60622 | 2020-01-17 |
1720620545 | Emily Claire Bonanno | Counselor | 1397 N Miwaukee Ave, Chicago, IL 60622 | 2019-10-14 |
1891342093 | Taylor Mallon | Speech-Language Pathologist | 8870 South Duffy Avenue, Apartment 406, Chicago, IL 60622 | 2019-08-22 |
1083260277 | Maggie Inman | Student in an Organized Health Care Education/Training Program | 1431 N Claremont Avenue, 2nd Floor Pavilion, Chicago, IL 60622 | 2019-08-13 |
1174176168 | Karol Maricel Quelal Analuisa | Internal Medicine | 1901 W Harrison, Chicago Il 60612-3714, Chicago, IL 60622 | 2019-07-19 |
1073076105 | Nichole Galullo | Social Worker | 1431 N Claremont 2nd Floor, Chicago, IL 60622 | 2019-04-06 |
1003375122 | Alfredo Delgado Perez Sr. | Psychologist | 1127 N Oakley Bvl 3 Floor, Chicago, IL 60622 | 2019-03-18 |
1841773439 | Abigail Hector | Counselor | 1521 N Milwaukee Ave, 3n, Chicago, IL 60622 | 2018-09-11 |
1164916144 | Dorothy Mitkowski | Student in an Organized Health Care Education/Training Program | 1127 N. Oakley Blvd., 2nd Floor, Chicago, IL 60622 | 2018-06-21 |
1255825121 | Kara Lynn Daniel | Speech-Language Pathologist | 1540 N Artesian Ave Apt 2r, Chicago, IL 60622 | 2018-06-14 |
Find all providers in zip 60622 |
Taxonomy Code | 320800000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment Facility, Mental Illness |
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245851690 | Brown Health Care Solutions LLC | Community Based Residential Treatment Facility, Mental Illness | 7330 S Blackstone Ave, Chicago, IL 60619-2150 | 2020-04-27 |
1376187617 | Haven Pointe L3c | Community Based Residential Treatment Facility, Mental Illness | 4056 W 115th St Apt 100, Chicago, IL 60655-4333 | 2019-10-30 |
1093209264 | Lester & Rosalie Anixter Center | Community Based Residential Treatment Facility, Mental Illness | 5108 W Roscoe St, Chicago, IL 60641-4204 | 2018-06-20 |
1376839274 | Community Mental Health Council, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2443 E 77th St, Chicago, IL 60649-4730 | 2011-06-20 |
1821384736 | Community Mental Health Council, Inc. | Community Based Residential Treatment Facility, Mental Illness | 7919 S Essex Ave, Chicago, IL 60617-1213 | 2011-06-20 |
1669768560 | Community Mental Health Council, Inc. | Community Based Residential Treatment Facility, Mental Illness | 8006 S Essex Ave, Chicago, IL 60617-1221 | 2011-06-20 |
1427344332 | Community Mental Health Council, Inc | Community Based Residential Treatment Facility, Mental Illness | 7131 S Western Ave, Chicago, IL 60636-3614 | 2011-06-20 |
1831485739 | Community Mental Health Council, Inc | Community Based Residential Treatment Facility, Mental Illness | 7133 S Western Ave, Chicago, IL 60636-3614 | 2011-06-20 |
1639465545 | Community Mental Health Council, Inc | Community Based Residential Treatment Facility, Mental Illness | 7701 S Phillips Ave, Chicago, IL 60649-4705 | 2011-06-20 |
1265727614 | Community Mental Health Council, Inc | Community Based Residential Treatment Facility, Mental Illness | 7623 S Essex Ave, Chicago, IL 60649-4037 | 2011-06-14 |
Find all providers in CHICAGO |
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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.