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ICAN COMMUNITY SERVICES INC. NFP NPI 1063702330


NPI Information

NPI: 1063702330
Provider Name: ICAN COMMUNITY SERVICES INC. NFP
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
15475 S PARK AVE
SUITE 109
SOUTH HOLLAND, IL
ZIP 60473
Phone: (708) 596-5680
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ICAN COMMUNITY SERVICES INC. NFP is a community behavioral health in South Holland, IL. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. ICAN COMMUNITY SERVICES INC. NFP NPI is 1063702330. The provider is registered as an organization entity type.

The provider's business location address is:

15475 S PARK AVE
SUITE 109
SOUTH HOLLAND, IL
ZIP 60473-328
Phone: (708) 596-5680

The provider's authorized official is Anthony Olujimi .
The authorized official title is President/ceo and has the following contact phone number (708) 297-8580.

The enumeration date for this NPI number is 4/7/2011 and was last updated on 12/22/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2800XClinic/CenterMethadoneA-5212-0001-AILLINOISNo
2261QR0405XClinic/CenterRehabilitation, Substance Use DisorderA-5212-0001-AILLINOISNo
3251S00000XCommunity/Behavioral HealthA-5212-0001-AILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1IL-10,172MOTHERILLINOISFDA NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.