Home Sweet Home Early Developmental Rehab

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

HOME SWEET HOME EARLY DEVELOPMENTAL REHAB

Practice address

201 Lester Rd
Park Forest, IL 60466-2013

Phone

(708) 645-6489

Fax

(866) 430-3316

NPI assigned

Jan 18, 2010

Last updated

Jan 18, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Harvell Floyd Jr.

Title

Executive Director

Phone

(708) 645-6489

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1263772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263772800000",
    "number": "1528399425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LESTER RD",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604662013",
            "telephone_number": "708-645-6489",
            "fax_number": "866-430-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LESTER RD",
            "city": "PARK FOREST",
            "state": "IL",
            "postal_code": "604662013",
            "telephone_number": "708-645-6489",
            "fax_number": "866-430-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME SWEET HOME EARLY DEVELOPMENTAL REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-18",
        "last_updated": "2010-01-18",
        "status": "A",
        "authorized_official_last_name": "FLOYD",
        "authorized_official_first_name": "HARVELL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-645-6489",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; 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.