NPIMap

Organization Active NPI

Plcca,Inc.

  • Community/Behavioral Health Agency
  • Maywood, IL
National Provider Identifier
1457539223
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
0-577-0183-P Issued in IL
Legal business name
PLCCA,INC.
Practice address
411 Madison St
Maywood, IL 60153-2136
Phone
(708) 450-3500
Fax
(708) 236-5186
NPI assigned
Feb 4, 2008
Organization subpart
Yes
Parent organization
PLCCA,INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. Claude Porter, BISHOP
Title
Pastor
Phone
(708) 450-3506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 0-577-0183-P IL Primary

Addresses

Primary practice location

411 Madison St
Maywood, IL 60153-2136

Mailing address

411 Madison St
Maywood, IL 60153-2136
Phone (708) 450-3500

Other names 1

  • Proviso Leyden Council for Community Action Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Proviso-Leyden Council9 organizations share this tax ID, including this one
Part of
Proviso-Leyden Council

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1457539223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 MADISON ST",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601532136",
            "telephone_number": "708-450-3500",
            "fax_number": "708-236-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 MADISON ST",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601532136",
            "telephone_number": "708-450-3500",
            "fax_number": "708-236-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLCCA,INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PLCCA,INC.",
        "enumeration_date": "2008-02-04",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "CLAUDE",
        "authorized_official_title_or_position": "PASTOR",
        "authorized_official_telephone_number": "708-450-3506",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BISHOP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "0-577-0183-P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proviso Leyden Council for Community Action",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maywood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.