DEPARTMENT OF HEALTH AND HUMAN SERVICES

NPI # 

Practice Address:

14714 State St

Dolton, IL, 60419-1517

Practice Phone:

708-267-3088

License Number:

041296287

License State:

IL

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Mental Health (Including Community Mental Health Center)

Taxonomy Code:

261QM0801X

Updated by NPPES on 3/30/2017. You can view the original data set for NPI # 1457883431 on the official NPPES website. If the information about this NPI provider/company is outdated you can request updates through the NPPES website. See our FAQ page for more information.

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DEPARTMENT OF HEALTH AND HUMAN SERVICES's

CMS CPT® coding data

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DEPARTMENT OF HEALTH AND HUMAN SERVICES's

CMS prescription data

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