Active NPI
Groups Recover Together - Illinois LLC
- Adult Mental Health Clinic/Center
- Lansing, IL
National Provider Identifier
1558058685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Mental Health Clinic/Center
- Legal business name
- GROUPS RECOVER TOGETHER - ILLINOIS LLC
- Practice address
- 2457 Ridge Rd
Lansing, IL 60438-2711 - Phone
- (800) 683-8313
- NPI assigned
- Apr 19, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Colleen Nicewicz
- Title
- Ceo
- Phone
- (413) 281-3035
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| Adult Medicine Physician | 207QA0505X | |||
| Internal Medicine Physician | 207R00000X | |||
| Psychiatry Physician | 2084P0800X | |||
| Adult Mental Health Clinic/Center | 261QM0850X | Primary | ||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X | |||
| Family Nurse Practitioner | 363LF0000X |
Addresses
Primary practice location
2457 Ridge Rd
Lansing, IL 60438-2711
Mailing address
111 S Bedford St Ste 205
Burlington, MA 01803-5145
Phone (512) 439-3547
National Provider Directory
National Provider Directory- Tax ID family
- Recover Together Inc
Other organizations with this tax ID 8
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Mental Health Clinic/Center
- Burlington, MA
- NPI 1174928873
-
- Adult Mental Health Clinic/Center
- Burlington, MA
- NPI 1275161622
-
- Adult Mental Health Clinic/Center
- Burlington, MA
- NPI 1306240312
-
- Adult Mental Health Clinic/Center
- Burlington, MA
- NPI 1396373742
-
- Adult Mental Health Clinic/Center
- Burlington, MA
- NPI 1447649538
-
- Adult Mental Health Clinic/Center
- Burlington, MA
- NPI 1801424171
-
- Psychiatry Physician
- Las Vegas, NV
- NPI 1871297010
-
- Adult Mental Health Clinic/Center
- Burlington, MA
- NPI 1871982801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681862400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1683504000000",
"number": "1558058685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 S BEDFORD ST STE 205",
"city": "BURLINGTON",
"state": "MA",
"postal_code": "018035145",
"telephone_number": "512-439-3547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2457 RIDGE RD",
"city": "LANSING",
"state": "IL",
"postal_code": "604382711",
"telephone_number": "800-683-8313"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GROUPS RECOVER TOGETHER - ILLINOIS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-04-19",
"last_updated": "2023-05-08",
"certification_date": "2023-05-08",
"status": "A",
"authorized_official_last_name": "NICEWICZ",
"authorized_official_first_name": "COLLEEN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "413-281-3035"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QA0505X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Adult Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lansing, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.