Southwest Disabilities Services & Support NFP

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

SOUTHWEST DISABILITIES SERVICES & SUPPORT NFP

Practice address

286 E 16TH St
Chicago Heights, IL 60411-3730

Phone

(708) 753-1670

Fax

(708) 753-1679

NPI assigned

Jul 1, 2009

Last updated

May 13, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Reuben Frederick Goodwin Sr.

Title

Executive Director

Phone

(708) 753-1670

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1033347794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 E 16TH ST",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113730",
            "telephone_number": "708-753-1670",
            "fax_number": "708-753-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 E 16TH ST",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604113730",
            "telephone_number": "708-753-1670",
            "fax_number": "708-753-1679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST DISABILITIES SERVICES & SUPPORT NFP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-01",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "REUBEN",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-753-1670",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.