New Leaf Wellness & Behavioral Health

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

NEW LEAF WELLNESS & BEHAVIORAL HEALTH

Practice address

22100 Meadow Lake PL
Richton Park, IL 60471-1299

Phone

(219) 973-7159

NPI assigned

Apr 30, 2021

Organization subpart

No

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

Authorized official

Name

Kim Anderson, FNP-B.C.

Title

Owner

Phone

(219) 973-7159

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1396328183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22100 MEADOW LAKE PL",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711299",
            "telephone_number": "219-973-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22100 MEADOW LAKE PL",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711299",
            "telephone_number": "219-973-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LEAF WELLNESS & BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-30",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-973-7159",
        "authorized_official_credential": "FNP-B.C."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Richton Park, IL
• Providers in Richton Park, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.