CTF Illinois

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

CTF ILLINOIS

Doing business as

CTF Access-Supr

Practice address

530 E 162ND St
South Holland, IL 60473-2326

Phone

(708) 429-1260

Fax

(708) 429-9170

NPI assigned

Nov 4, 2021

Last updated

Jan 12, 2022By 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

Kelli L Cody

Title

Executive Assistant

Phone

(708) 429-1260

Specialties & licenses 5

Addresses

Other names 1

• CTF ACCESS-SUPR Doing business as

Electronic endpoints 1

Tax ID family

Charleston Transitional Facility9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

• CTF

  dba Charleston Transitional Facility

  • Developmentally Disabled Services Day Training Agency
  • Homewood, IL
  • NPI 1306118997
  NPD tax ID
• CTF Illinois

  dba ACCESS Psychological Services

  • Non-emergency Medical Transport (VAN)
  • South Holland, IL
  • NPI 1194183699
  NPD tax ID
• CTF Illinois

  dba ACCESS Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • South Holland, IL
  • NPI 1356706881
  NPD tax ID
• CTF Illinois

  dba ACCESS Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Charleston, IL
  • NPI 1437733979
  NPD tax ID
• CTF Illinois

  • Adult Mental Health Clinic/Center
  • Orland Park, IL
  • NPI 1528992385
  NPD tax ID
• CTF Illinois

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Orland Park, IL
  • NPI 1679667737
  NPD tax ID
• CTF Illinois

  dba CTF Illinois -Reynolds MH

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Charleston, IL
  • NPI 1699372250
  NPD tax ID
• CTF Illinois

  dba ACCESS Behavioral Health

  • Adult Mental Health Clinic/Center
  • Orland Park, IL
  • NPI 1770949661
  NPD tax ID

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1689339590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18230 ORLAND PKWY",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675688",
            "telephone_number": "708-429-1260",
            "fax_number": "708-429-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 E 162ND ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732326",
            "telephone_number": "708-429-1260",
            "fax_number": "708-429-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CTF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-04",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "CODY",
        "authorized_official_first_name": "KELLI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "708-429-1260"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "endpointDescription": "NA",
            "address_1": "530 E 162nd St",
            "city": "South Holland",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604732326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CTF ACCESS-SUPR",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CTF ACCESS-SUPR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Crain Diagnostics PLLC
• Sandre Leona Crain, FNP-BC
• Debra Crockett
• CTF Illinois (ACCESS Psychological Services)
• CTF Illinois (ACCESS Behavioral Health)
• Rebecca Cummings, FNP-BC
• Danielle a Marshall Speech-Language Consulting Services
• Francine Yavette Davis, LPC
• Javier Martin Davis, PHARMD.
• Kara Ellen Davis, MD

• Substance Use Disorder Rehabilitation Clinic/Center in South Holland, IL
• Providers in South Holland, IL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.