Community Regional Services Inc.

Primary specialty

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

Legal business name

COMMUNITY REGIONAL SERVICES INC.

Practice address

18765 Forest View LN
Lansing, IL 60438-4513

Phone

(708) 673-7564

NPI assigned

Jul 14, 2021

Last updated

Jul 14, 2021By 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

Bolanle Adeoye

Title

Executive Director

Phone

(773) 615-7648

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1619549151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18765 FOREST VIEW LN",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604384513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18765 FOREST VIEW LN",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604384513",
            "telephone_number": "708-673-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY REGIONAL SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "ADEOYE",
        "authorized_official_first_name": "BOLANLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "773-615-7648"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Edward Cole, CRNA
• Cheryl Lee Cole, LCPC, LMFT
• Janine Coleman
• Community Health Services LLC
• Community Homemaker Services Inc.
• Shartearra Conigan
• Madeline M Connor, M.S., CCC-SLP
• Kass Janel Cooper, LCSW
• Brittany Suzanne Cornejo
• Joshua Cottrill, LCSW

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lansing, IL
• Providers in Lansing, 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 Jul 14, 2021; 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.