Epic Commiunity Development Center, Incorported

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EPIC COMMIUNITY DEVELOPMENT CENTER, INCORPORTED

Practice address

905 175TH St Ste 3NE
Homewood, IL 60430-2057

Phone

(708) 991-2221

Fax

(708) 589-1368

NPI assigned

Feb 8, 2023

Organization subpart

No

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

Authorized official

Name

Albert Cooper

Title

Executive Director

Phone

(708) 991-2221

Specialties & licenses 2

Addresses

Tax ID family

Epic Commiunity Development Center Incorported2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Epic Commiunity Development Center, Incorported

  • Case Management Agency
  • Park Forest, IL
  • NPI 1790257723
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carmen King

  • Mental Health Counselor
  • Homewood, IL
  • NPI 1538934963
  NPD

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

{
    "created_epoch": "1675814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1952008237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 175TH ST STE 3NE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302057",
            "telephone_number": "708-991-2221",
            "fax_number": "708-589-1368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 175TH ST STE 3NE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302057",
            "telephone_number": "708-991-2221",
            "fax_number": "708-589-1368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIC COMMIUNITY DEVELOPMENT CENTER, INCORPORTED",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-08",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-991-2221"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dori Lee Elmore
• Dariel L Embry-Rodgers, LPC, NCC
• Emporium Beauty Spa LLC
• Empowering Beahvioral Health and Consulting Services
• Endodontic & Periodontic Associates, LTD
• Equal Steps Therapy Services, P. C.
• Thomas Walton Erickson, DDS
• Ma Aurora Emma Altuna Estrada, AGAC-NP
• Rose Ette
• Eunoia Wellness Boutique

• Mental Health Clinic/Center (Including Community Mental Health Center) in Homewood, IL
• Providers in Homewood, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.