N Hyacinth Home LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

N HYACINTH HOME LLC

Practice address

2418 W Jackson Blvd
Chicago, IL 60612-2938

Phone

(312) 468-9075

Fax

(864) 383-6062

NPI assigned

Jul 2, 2024

Organization subpart

No

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

Authorized official

Name

Sherann Ivy, APN

Title

Ceo

Phone

(312) 468-9075

Specialties & licenses 1

Addresses

Other names 1

• Hyacinth Home Doing business as

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1336985159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 W JACKSON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122938",
            "telephone_number": "312-468-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 W JACKSON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122938",
            "telephone_number": "312-468-9075",
            "fax_number": "864-383-6062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N HYACINTH HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "IVY",
        "authorized_official_first_name": "SHERANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-468-9075",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hyacinth Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Chicago, IL
• Providers in Chicago, IL by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.