The Dubois Douglas Centres

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

199500004C Issued in IL

Legal business name

THE DUBOIS DOUGLAS CENTRES

Practice address

4747 Lincoln Mall Dr
Suite 301
Matteson, IL 60443-3811

Phone

(708) 283-0886

Fax

(708) 283-0895

NPI assigned

Jul 15, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Marcel Martins-Mensah

Title

President

Phone

(708) 283-0886

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436918400000",
    "number": "1386028835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 LINCOLN MALL DR",
            "address_2": "SUITE 301",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433811",
            "telephone_number": "708-283-0886",
            "fax_number": "708-283-0895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 LINCOLN MALL DR",
            "address_2": "SUITE 301",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433811",
            "telephone_number": "708-283-0886",
            "fax_number": "708-283-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DUBOIS DOUGLAS CENTRES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-15",
        "last_updated": "2015-07-15",
        "status": "A",
        "authorized_official_last_name": "MARTINS-MENSAH",
        "authorized_official_first_name": "MARCEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-283-0886",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "199500004C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.