Organization · NPI-2

1863fwd Care 2 Care Nfp

Community/Behavioral Health · Chicago, IL

NPI number1790472355

StatusActive

Last updated in NPPESApr 24, 2023

Details

NPI: 1790472355
Entity type: Organization (NPI-2)
Legal business name: 1863fwd Care 2 Care Nfp
Organization subpart: No
Enumeration date: Apr 24, 2023
Certification date: Apr 22, 2023
Last updated: Apr 24, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
251S00000X	Community/Behavioral Health	–	–	Yes
261QM0801X	Clinic/Center, Mental Health (Including Community Mental Health Center)	–	–
261QM0855X	Clinic/Center, Adolescent and Children Mental Health	–	–
311500000X	Alzheimer Center (Dementia Center)	–	–
343900000X	Non-emergency Medical Transport (VAN)	–	–
347C00000X	Private Vehicle	–	–
347E00000X	Transportation Broker	–	–

Other names

1863fwd Care 2 Care (Doing Business As)
1863 Care 2 Care (Doing Business As)

Practice location

243 W 95th St
Chicago, IL 60628-1375

Phone 708-491-3303

Mailing address

Po Box 717
Glenwood, IL 60425-0717

Phone 708-491-3303

Authorized official

Jataun Rollins
Ceo
7084913303

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