Provider Demographics
NPI:1689036519
Name:TRANSFORMING, EDUCATING, & EMPOWERING CHILDREN AND HUMANITY
Entity Type:Organization
Organization Name:TRANSFORMING, EDUCATING, & EMPOWERING CHILDREN AND HUMANITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ROCHELLE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:CADC, NCRS, RCT
Authorized Official - Phone:224-406-3798
Mailing Address - Street 1:1750 W 103RD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-2821
Mailing Address - Country:US
Mailing Address - Phone:224-406-3798
Mailing Address - Fax:773-779-0125
Practice Address - Street 1:1750 W 103RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-2821
Practice Address - Country:US
Practice Address - Phone:224-406-3798
Practice Address - Fax:773-779-0125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-21
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1689036519Medicaid