NPIMap

Organization Active NPI

Arden Shore Child and Family Services

  • Community/Behavioral Health Agency
  • Waukegan, IL
National Provider Identifier
1134441173
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ARDEN SHORE CHILD AND FAMILY SERVICES
Practice address
2504 Washington St
Suite 200
Waukegan, IL 60085-4983
Phone
(847) 662-4464
Fax
(847) 662-4530
NPI assigned
Feb 18, 2010
Last updated
Feb 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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

Authorized official

Name
Ms. Jeanette Oliver
Title
Quality Assurance Manager
Phone
(847) 549-1730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

2504 Washington St
Suite 200
Waukegan, IL 60085-4983

Mailing address

935 Lakeview Pkwy
Suite 105
Vernon Hills, IL 60061-1443
Phone (847) 549-1730

Other identifiers 1

IdentifierTypeStateIssuer
2B05CHR018MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Arden Shore Child and Family Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1134441173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 LAKEVIEW PKWY",
            "address_2": "SUITE 105",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611443",
            "telephone_number": "847-549-1730",
            "fax_number": "847-549-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 WASHINGTON ST",
            "address_2": "SUITE 200",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854983",
            "telephone_number": "847-662-4464",
            "fax_number": "847-662-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARDEN SHORE CHILD AND FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-18",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "QUALITY ASSURANCE MANAGER",
        "authorized_official_telephone_number": "847-549-1730",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2B05CHR018",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.