Ican Community Services Inc. Nfp
LBN: Ican Community Services Inc. Nfp
Ican Community Services Inc. Nfp is an health care organization with primary practice located at 15475 S Park Ave Suite 109, South Holland IL 60473-1328. The organization recently has 3 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Methadone, Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Agencies / Community/Behavioral Health is the primary health care specialty.
Ican Community Services Inc. Nfp can be contacted via phone (708) 596-5680, or through Olujimi, Anthony via phone (708) 297-8580.
Contact Information
Primary practice address
15475 S Park Ave Suite 109
South Holland IL 60473-1328
Phone: (708) 596-5680
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Community/Behavioral Health | 251S00000X | A-5212-0001-A | Illinois |
| Ambulatory Health Care Facilities / Methadone | 261QM2800X | A-5212-0001-A | Illinois |
| Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder | 261QR0405X | A-5212-0001-A | Illinois |
Profile Details
| NPI number | 1063702330 |
|---|---|
| LBN Legal business name | Ican Community Services Inc. Nfp |
| DBA Doing business as | |
| Authorized official | Olujimi, Anthony M.D, MPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 7th, 2011 |
| Last updated | Dec 22nd, 2017 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063702330 | NPPES |
| Illinois | Other | IL-10,172M | FDA NUMBER |
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