Good Vibes

Primary specialty

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

Legal business name

GOOD VIBES

Practice address

18050 Michael Ave
Country Club Hills, IL 60478-5022

Phone

(773) 301-6754

NPI assigned

Jan 27, 2021

Organization subpart

No

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

Authorized official

Name

Michael Davis

Title

Owner

Phone

(773) 301-6754

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1871184572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18050 MICHAEL AVE",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604785022",
            "telephone_number": "773-301-6754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18050 MICHAEL AVE",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604785022",
            "telephone_number": "773-301-6754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD VIBES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-301-6754"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grady Louis Garner II, M.D.
• Shirlyn Garrett
• Dominique Gilmore
• Latoya Nashage Glass-Sherman, D.C.
• Joaquim L. Godfrey
• Grand Prairie Services
• Lorraine Griffen
• Kathy Griffith
• Sydney Lavelle Guyton
• Leron Hargrove-Head

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Country Club Hills, IL
• Providers in Country Club Hills, 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 Oct 5, 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.