Motherland Sheltered Services Inc

Primary specialty

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

Legal business name

MOTHERLAND SHELTERED SERVICES INC

Practice address

14921 Perry Ave
South Holland, IL 60473-1044

Phone

(630) 863-0722

NPI assigned

May 15, 2023

Organization subpart

No

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

Authorized official

Name

Ayodeji Adegoye

Title

President/Ceo

Phone

(630) 863-0722

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1386334142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2735 HASSERT BLVD, STE 135, #681",
            "address_2": "C/O AYODEJI ADEGOYE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60564",
            "telephone_number": "630-863-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14921 PERRY AVE",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731044",
            "telephone_number": "630-863-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOTHERLAND SHELTERED SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-13",
        "status": "A",
        "authorized_official_last_name": "ADEGOYE",
        "authorized_official_first_name": "AYODEJI",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "630-863-0722"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in South Holland, IL
• Providers in South Holland, 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 May 15, 2023; 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.