Exoffender Transition Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

EXOFFENDER TRANSITION CENTER

Practice address

2630 S Wabash Ave Rear
Chicago, IL 60616-2825

Phone

(312) 808-3210

Fax

(312) 949-1610

NPI assigned

Jan 9, 2018

Organization subpart

No

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

Authorized official

Name

Christine Lang Applewhite, MSP, CADC, LCPC

Title

Vice President & Clinical Director

Phone

(312) 808-3210

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Reentry & Rehabilitation Transition Center, NFP Doing business as

Locations

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515456000000",
    "number": "1992212161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 S WABASH AVE REAR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162825",
            "telephone_number": "312-808-3210",
            "fax_number": "312-949-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 S WABASH AVE REAR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162825",
            "telephone_number": "312-808-3210",
            "fax_number": "312-949-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXOFFENDER TRANSITION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-09",
        "last_updated": "2018-01-09",
        "status": "A",
        "authorized_official_last_name": "LANG APPLEWHITE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "VICE PRESIDENT & CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "312-808-3210",
        "authorized_official_credential": "MSP, CADC, LCPC"
    },
    "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": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275057705",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14055583",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reentry & Rehabilitation Transition Center, NFP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; 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.