NPIMap

Organization Active NPI

Sadie Waterford Manor Assessment and Therapy Center

  • Mental Health Counselor
  • Harvey, IL
National Provider Identifier
1306980321
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
149000537 Issued in IL
Legal business name
SADIE WATERFORD MANOR ASSESSMENT AND THERAPY CENTER
Practice address
174 E 154TH St Ste 200
Harvey, IL 60426-3302
Phone
(708) 339-0040
Fax
(708) 339-0290
NPI assigned
Feb 16, 2007
Organization subpart
Yes
Parent organization
HALFWAY HOUSE COMMITTEE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Authorized official

Name
Mr. Lester P Harris, BA
Title
Executive Director
Phone
(708) 339-0040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 149000537 IL Primary

Addresses

Primary practice location

174 E 154TH St Ste 200
Harvey, IL 60426-3302

Mailing address

174 E 154TH St Ste 200
Harvey, IL 60426-3302
Phone (708) 339-0040

Other names 1

  • Halfway House Committee, Inc. Other name

National Provider Directory

National Provider Directory
Part of
Halfway House Committee Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1306980321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 E 154TH ST STE 200",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263302",
            "telephone_number": "708-339-0040",
            "fax_number": "708-339-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 E 154TH ST STE 200",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263302",
            "telephone_number": "708-339-0040",
            "fax_number": "708-339-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SADIE WATERFORD MANOR ASSESSMENT AND THERAPY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HALFWAY HOUSE COMMITTEE, INC.",
        "enumeration_date": "2007-02-16",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "LESTER",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-339-0040",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149000537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Halfway House Committee, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Harvey, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.