ONE DIRECTION FORWARD INC. NPI 1982340220

NPI Information

NPI: 1982340220
Provider Name: ONE DIRECTION FORWARD INC.
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
4747 LINCOLN MALL DR STE 412
MATTESON, IL
ZIP 60443
Phone: (708) 300-6977
Get Directions

ONE DIRECTION FORWARD INC. is an adult mental health clinic center in Matteson, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. ONE DIRECTION FORWARD INC. NPI is 1982340220. The provider is registered as an organization entity type.

The provider's business location address is:

4747 LINCOLN MALL DR STE 412
MATTESON, IL
ZIP 60443-821
Phone: (708) 300-6977
Fax: (708) 300-6978

The provider's authorized official is Kenneth Simpson .
The authorized official title is Ceo and has the following contact phone number (708) 300-6977.

The enumeration date for this NPI number is 5/10/2022 and was last updated on 5/10/2022.

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
1	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			No
2	261QM0850X	Clinic/Center	Adult Mental Health			Yes

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
1	1215392931	MEDICAID	ILLINOIS

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

NPI Synchronization or Removal

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