NPIMap

Organization Active NPI

Autism Home Support Services

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Northbrook, IL
National Provider Identifier
1356739478
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
0-14-5913 Issued in IL
Legal business name
AUTISM HOME SUPPORT SERVICES
Practice address
85 Revere Dr
Northbrook, IL 60062-8001
Phone
(847) 564-0822
NPI assigned
Dec 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Authorized official

Name
Laura McKee
Title
Ceo
Phone
(847) 564-0822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 0-14-5913 IL Primary

Addresses

Primary practice location

85 Revere Dr
Northbrook, IL 60062-8001

Mailing address

85 Revere Dr
Northbrook, IL 60062-8001

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1356739478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 REVERE DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 REVERE DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628001",
            "telephone_number": "847-564-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM HOME SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "MCKEE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-564-0822"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "0-14-5913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.