ACCESS COMMUNITY EXPERIENCE, INC. (NPI# 1912353962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912353962 |
Entity Type | Organization |
Organization Name | ACCESS COMMUNITY EXPERIENCE, INC. |
Practice Address |
4530 S Woodlawn Ave Unit 104 Chicago IL 60653-4487 |
Practice Telephone | 7082713463 |
Practice Fax Number | 7739665437 |
Mailing Telephone | 7082713463 |
Mailing Fax Number | 7739665437 |
Enumeration Date | 2016-05-09 |
Last Update Date | 2016-05-09 |
Authorized Official Name | MR. MELAKU TADESSE (CEO) |
Authorized Official Telephone | 7082713463 |
Authorized Official Credential | QIDP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 201500011C | IL | Residential Treatment Facilities |
Street Address |
4530 S WOODLAWN AVE UNIT 104 |
City | CHICAGO |
State | IL |
Zip Code | 60653-4487 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881215804 | Pamela Ann Brazelton-sykes | Counselor | Pioneer Gardens Supportive Living, 3800 S King Dr, Chicago, IL 60653 | 2020-04-30 |
1962915439 | Pickup Transport Lllp | Non-emergency Medical Transport (VAN) | 4418 S. Oakenwald Ave, Chicago, IL 60653 | 2017-11-07 |
1245758309 | Qi Wellness LLC | Case Management | 525 E 46th Place, Chicago, IL 60653 | 2017-09-08 |
1598202897 | Fadesire O Ajuwon | Registered Nurse | 4218 S King Dr, 1n, Chicago, IL 60653 | 2017-01-24 |
1013464619 | Roundys Supermarkets Inc | Pharmacy | 3857 S Dr Martin Luther King Jr Dr, Chicago, IL 60653 | 2016-09-01 |
1417384793 | Griffin Orthodontics PC | Dentist | 1040 E 47th Street, Chicago, IL 60653 | 2013-10-02 |
1114350659 | Carita Dale Johnson | Pharmacist | 3753 S. Cottage Grove Ave, 104, Chicago, IL 60653 | 2013-08-20 |
1245677848 | Mercy Diagnostic and Treatment Center | Clinic/Center | 3755 S Cottage Grove, Chicago, IL 60653 | 2013-05-23 |
1952745937 | Mercy Community Pharmacy At Oakwood Shores | Pharmacy | 3753 S. Cottage Grove, Chicago, IL 60653 | 2013-04-22 |
1386952315 | Jami S Little | Developmental Therapist | 617 East 41st, Chicago, IL 60653 | 2010-09-24 |
Find all providers in zip 60653 |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770116287 | Universal Homes LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12101 S La Salle St, Chicago, IL 60628-6618 | 2020-02-13 |
1760014625 | Tomeka R Morgan | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11543 S Ashland Ave, Chicago, IL 60643-5001 | 2020-02-10 |
1457839821 | Adorn Health, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 190 South Lasalle Street, #2100, Chicago, IL 60603-0003 | 2018-07-30 |
1215423538 | Alyssa Jaye Saterfield | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1447 W Montrose Ave, Chicago, IL 60613-1348 | 2018-07-10 |
1336635135 | Essential Lifestyles LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7408 S Harvard Ave, Chicago, IL 60621-3424 | 2018-07-03 |
1184113987 | Ohana Community Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4931 W Thomas St, Chicago, IL 60651-3129 | 2018-05-07 |
1124523352 | Tylers Place | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7347 S Claremont Ave, Chicago, IL 60636-3627 | 2018-03-29 |
1992207724 | Universal Homes LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12512 S Wallace St, Chicago, IL 60628-7130 | 2018-03-07 |
1730623786 | A New Age Human Services Corp. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5328 W Parker Ave, Chicago, IL 60639-1521 | 2016-12-10 |
1831643121 | Lajaed Corporation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8026 S Wood St, Chicago, IL 60620-4546 | 2016-08-04 |
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.