Active NPI
Universal Homes LLC
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Chicago, IL
National Provider Identifier
1770116287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Legal business name
- UNIVERSAL HOMES LLC
- Practice address
- 12101 S la Salle St
Chicago, IL 60628-6618 - Phone
- (773) 981-7171
- Fax
- (773) 337-0635
- NPI assigned
- Feb 13, 2020
- Last updated
- Jan 4, 2021
- 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
- Joanne Young
- Title
- Executive Director
- Phone
- (773) 981-7171
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Primary |
Addresses
Primary practice location
12101 S la Salle St
Chicago, IL 60628-6618
Mailing address
3473 S King Dr # 133
Chicago, IL 60616-4108
Phone (773) 981-7171
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201800004C | Medicaid | IL |
Other names 1
- Universal Homes
National Provider Directory
National Provider Directory- Tax ID family
- Universal Homes
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Chicago, IL
- NPI 1992207724
Locations
3473 S King Dr
#133
Chicago, IL 60616
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581552000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1609718400000",
"number": "1770116287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3473 S KING DR # 133",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606164108",
"telephone_number": "773-981-7171",
"fax_number": "773-337-0635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12101 S LA SALLE ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606286618",
"telephone_number": "773-981-7171",
"fax_number": "773-337-0635"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNIVERSAL HOMES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-02-13",
"last_updated": "2021-01-04",
"certification_date": "2021-01-04",
"status": "A",
"authorized_official_last_name": "YOUNG",
"authorized_official_first_name": "JOANNE",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "773-981-7171"
},
"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": "201800004C",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Universal Homes",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "Universal Homes",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.