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Contact Information

IT'S ABOUT CHANGE SOBER LIVING, INC.
1604 HORBOR ST.
CALUMET CITY, IL60409
 Phone: 708-360-3205
 Fax: 708-868-8335
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for IT'S ABOUT CHANGE SOBER LIVING, INC.

NPI Number 1801336961
LBN Legal business name IT'S ABOUT CHANGE SOBER LIVING, INC.
Authorized official ANTHONY DILLARD - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 03/08/2017
Last updated 03/08/2017 - About 9 years ago
Identifiers
IL License # A-8723-0003-A
IL Medicaid C/A-8723-0003-A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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