HEPHZIBAH CHILDREN'S ASSOCIATION NPI 1992767602

NPI Information

NPI: 1992767602
Provider Name: HEPHZIBAH CHILDREN'S ASSOCIATION
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 14D2202507

Address:
946 NORTH BLVD
OAK PARK, IL
ZIP 60301
Phone: (708) 649-7100
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HEPHZIBAH CHILDREN'S ASSOCIATION is a mental health (including community mental health center) clinic center in Oak Park, IL. HEPHZIBAH CHILDREN'S ASSOCIATION NPI is 1992767602. The provider is registered as an organization entity type.

The provider's business location address is:

946 NORTH BLVD
OAK PARK, IL
ZIP 60301-205
Phone: (708) 649-7100
Fax: (708) 649-7102

The provider's authorized official is Merry Beth Sheets .
The authorized official title is Executive Director and has the following contact phone number (708) 649-7100.

The CLIA number assigned to this NPI record is 14D2202507 - other - child welfare -res center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/6/2006 and was last updated on 1/8/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

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This page was last updated on: 5/5/2024

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