NPIMap

Organization Active NPI

Bobby E Wright Ccmhc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
National Provider Identifier
1831367036
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BOBBY E WRIGHT CCMHC
Practice address
3525 W Jackson Blvd
Chicago, IL 60624-3255
Phone
(773) 722-7900
Fax
(773) 722-0644
NPI assigned
Feb 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Authorized official

Name
Simone Edwards
Title
Cfo
Phone
(773) 722-7900

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Mental Illness Community Based Residential Treatment Facility 320800000X IL
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

Primary practice location

3525 W Jackson Blvd
Chicago, IL 60624-3255

Mailing address

5002 W Madison St
Chicago, IL 60644-4127
Phone (773) 722-7900

National Provider Directory

National Provider Directory
Tax ID family
Bobby E Wright Comprehensive Behavioral Health Center Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

3525 W Jackson Blvd
Chicago, IL 60624
Phone (773) 722-7900

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597968000000",
    "number": "1831367036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606444127",
            "telephone_number": "773-722-7900",
            "fax_number": "773-722-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 W JACKSON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606243255",
            "telephone_number": "773-722-7900",
            "fax_number": "773-722-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOBBY E WRIGHT CCMHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "SIMONE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "773-722-7900"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 21, 2020; 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.