NPI: 1023442753
Provider Name: PLCCA
Doing Business As: PROVISO LEYDEN COUNCIL FOR COMMUNITY ACTION, INC.
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization
Specialization: Mental Health (Including Community Mental Health Center)
Address:
411 MADISON W ST
MAYWOOD, IL
ZIP 60153
Phone: (708) 450-3500
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PLCCA is a mental health (including community mental health center) clinic center in Maywood, IL. PLCCA NPI is 1023442753. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Proviso Leyden Council For Community Action, Inc..
The provider's business location address is:
411 MADISON W ST
MAYWOOD, IL
ZIP 60153-136
Phone: (708) 450-3500
The provider's authorized official is Pamela M Yates .
The authorized official title is Data/billing Specialist and has the following contact phone number (708) 450-3500.
The enumeration date for this NPI number is 8/29/2013 and was last updated on 8/5/2022.