BAAL PERAZIM WELLNESS INC NPI 1114547247

NPI Information

NPI: 1114547247
Provider Name: BAAL PERAZIM WELLNESS, INC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 14D2177546

Address:
3353 S MORGAN ST UNIT 1
CHICAGO, IL
ZIP 60608
Phone: (773) 565-4231
Get Directions

BAAL PERAZIM WELLNESS, INC is a mental health (including community mental health center) clinic center in Chicago, IL. BAAL PERAZIM WELLNESS, INC NPI is 1114547247. The provider is registered as an organization entity type.

The provider's business location address is:

3353 S MORGAN ST UNIT 1
CHICAGO, IL
ZIP 60608-885
Phone: (773) 565-4231
Fax: (833) 970-1077

The provider's authorized official is Maurice Brownlee .
The authorized official title is Executive Director and has the following contact phone number (773) 451-9444.

The CLIA number assigned to this NPI record is 14D2177546 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/18/2020 and was last updated on 4/18/2020.

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

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	253231187001	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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