Organization Active NPI

Senior Home Sharing, Inc.

Doing business as Senior Home Sharing

  • Mental Health Counselor
  • Lombard, IL
National Provider Identifier
1174194765
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SENIOR HOME SHARING, INC.
Doing business as
Senior Home Sharing
Practice address
1910 S Highland Ave Ste 135
Lombard, IL 60148-6147
Phone
(630) 407-0440
NPI assigned
Jul 6, 2021
Last updated
Feb 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Authorized official

Name
Rita Brosnan, LCPCNPI 1356612238
Title
Executive Director
Phone
(630) 407-0440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Assisted Living Facility 310400000X NU

Addresses

Primary practice location

1910 S Highland Ave Ste 135
Lombard, IL 60148-6147

Mailing address

1910 S Highland Ave Ste 135
Lombard, IL 60148-6147
Phone (630) 407-0440

Other names 1

  • Senior Home Sharing Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220301002037 IL Part B Supplier - Clinic/Group Practice 7618361023 Receives reassigned benefits from 3 practitioners
Practice locations: Lombard, IL

National Provider Directory

National Provider Directory

Locations

1910 S Highland Ave
Ste 135
Lombard, IL 60148
Phone (630) 407-0440

403 W Saint Charles Rd
Ste B
Lombard, IL 60148
Phone (630) 407-0440

Practitioners & affiliated clinicians

Practitioners 3

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": "1625529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643760000000",
    "number": "1174194765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 S HIGHLAND AVE STE 135",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486147",
            "telephone_number": "630-407-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 S HIGHLAND AVE STE 135",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486147",
            "telephone_number": "630-407-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR HOME SHARING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-06",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A",
        "authorized_official_last_name": "BROSNAN",
        "authorized_official_first_name": "RITA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "630-407-0440",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Senior Home Sharing",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Senior Home Sharing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lombard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.