Provider Demographics
NPI:1780200014
Name:ANCHORPOINT ADOLESCENT CONSULTANT GROUP INC.
Entity Type:Organization
Organization Name:ANCHORPOINT ADOLESCENT CONSULTANT GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPENY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-404-4848
Mailing Address - Street 1:1246 N YALE AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-4564
Mailing Address - Country:US
Mailing Address - Phone:847-404-4848
Mailing Address - Fax:
Practice Address - Street 1:1246 N YALE AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-4564
Practice Address - Country:US
Practice Address - Phone:847-404-4848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-23
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14895746Medicaid
IL14895746OtherCOMMERCIAL INSURANCE