PROVISO-LEYDEN COUNCIL FOR COMMUNITY ACTION INC
NPI 1134553076
Clinic/Center - Methadone in Maywood, IL

Q: What is Proviso-Leyden Council For Community Action Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

Active since August 28, 2013

411 MADISON ST, MAYWOOD, IL 60153(708) 236-5042 Get Directions Write a Review

NPPES record last updated: April 17, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 17, 2026, Dec 16, 2022, Sep 13, 2019 (3 updates tracked since 2019).

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About Proviso-leyden Council For Community Action Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVISO-LEYDEN COUNCIL FOR COMMUNITY ACTION INC (NPI 1134553076), doing business as Plcca, is a healthcare organization registered as a methadone in Maywood, Illinois and active in the NPI registry since August 2013. The organization lists Beverly Smith, Coo, as its authorized official.

NPPES Registry Identity

NPI1134553076

Entity TypeOrganization

Primary Taxonomy261QM2800X

Legal Business NamePROVISO-LEYDEN COUNCIL FOR COMMUNITY ACTION INC

Location Address411 MADISON STMaywood, IL 60153-2136

Mailing Address411 Madison StMaywood, IL 60153-2136 · (708) 450-3500

Phone(708) 236-5042

Organization SubpartNo

Authorized OfficialBeverly SmithCoo · (708) 236-5170

Enumeration DateAugust 28, 2013

Last NPPES UpdateApril 17, 20263 updates tracked since enumeration

NPPES CertifiedApril 17, 2026

✔ NPI 1134553076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities

Taxonomy Code261QM2800X

Definition

An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X

Also ListedRehabilitation, Substance Use Disorder UnitTaxonomy 276400000X

411 MADISON ST, Maywood, IL 60153

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Other Names 1

Doing Business AsPlcca

Other Identifiers 1

Medicaid1215987003IL

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm G2067

Medication Assisted Treatment (MAT) with methadone is a comprehensive approach to manage opioid addiction. It includes weekly methadone dispensing, substance use counseling, individual and group therapy sessions, and toxicology tests as needed, all provided by a Medicare-enrolled opioid treatment program.

268 services11 patients

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAKE CLIFTON KELOW III LSW/CADC/ATE/COPD I

Social Worker (Clinical)