Provider Demographics
NPI:1376227173
Name:OPEN DOOR SERVICES
Entity Type:Organization
Organization Name:OPEN DOOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:708-374-0747
Mailing Address - Street 1:19821 MARGARET CT
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60411-6302
Mailing Address - Country:US
Mailing Address - Phone:708-374-0747
Mailing Address - Fax:
Practice Address - Street 1:19821 MARGARET CT
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60411-6302
Practice Address - Country:US
Practice Address - Phone:708-374-0747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPEN DOOR BEHAVIOR SOLUTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities