GRAND PRAIRIE SERVICES – NPI #1447212543
Clinic/Center

GRAND PRAIRIE SERVICES is an AHC clinic located in FLOSSMOOR, IL. NPPES has assigned the NPI number 1447212543 to GRAND PRAIRIE SERVICES on April 04, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QM0801X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Mental Health (Including Community Mental Health Center)

The NPI profile was previously updated about 3 years ago on Nov 20, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GRAND PRAIRIE SERVICES below.

NPI Profile for
GRAND PRAIRIE SERVICES

NPI Number
1447212543
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GRAND PRAIRIE SERVICES
Primary location
19530 KEDZIE AVENUE
FLOSSMOOR, IL 60422
Phone: (708) 799-2200 Fax: (708) 799-2711
Mailing address
17746 S OAK AVENUE
TINLEY PARK, IL 60477
Phone: (708) 444-1012 Fax: (708) 614-9449
Organization Subpart
No
Authorized Official
SHARRONNE WARD
PRESIDENT & CEO
Phone: (708) 444-1012
Updated
Certification Date
Nov 20, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM0801X
- Clinic/Center / Mental Health (Including Community Mental Health Center) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.