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General NPI Number Information
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NPI Number | 1184836470
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Entity Type | Organization
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Legal Business Name | SPECIAL NEEDS SPECIALISTS INC.
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 10/31/2016
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Provider Practice Location Address
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Address Line | 1250 N CONVENT ST SUITE B
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City | BOURBONNAIS
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State | IL
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Zip | 60914-1085
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Country | US
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Telephone | 815-935-4663
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Fax | 815-935-4660
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Provider Business Mailing Address
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Address Line | 1250 N. CONVENT STREET SUITE B
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City | BOURBONNAIS
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State | IL
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Zip | 60914-1006
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Country | US
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Telephone | 815-935-4663
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Fax | 815-935-4660
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. MICHAEL JOYCE
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Credential | RN
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Telephone | 815-935-4663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1010830
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License Number State | IL
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