Childrens Advocate
Behavior Analyst in Olympia Fields, IL. Organization (NPI-2).
NPI number1104489244
StatusActive
Last updated in NPPESNov 30, 2020
Details
- NPI
- 1104489244
- Entity type
- Organization (NPI-2)
- Legal business name
- Childrens Advocate
- Organization subpart
- No
- Enumeration date
- Apr 15, 2019
- Certification date
- Nov 30, 2020
- Last updated
- Nov 30, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | – | – | Yes |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – |
Practice location
2517 Athens RdOlympia Fields, IL 60461-1955
Phone 708-743-9090
Mailing address
2517 Athens RdOlympia Fields, IL 60461-1955
Other practice locations
4747 Lincoln Mall Dr Ste 407
Matteson, IL 60443-3821
Matteson, IL 60443-3821
Phone 708-573-1800 · Fax 708-283-1806
Authorized official
Reenee Jackson
Owner
7087439090
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