Organization · NPI-2

A Beautiful Mind, INC

Community Based Residential Treatment Facility, Mental Illness · Chicago, IL

NPI number1245830298
StatusActive
Last updated in NPPESFeb 28, 2023

Details

NPI
1245830298
Entity type
Organization (NPI-2)
Legal business name
A Beautiful Mind, INC
Organization subpart
No
Enumeration date
Oct 29, 2020
Certification date
Feb 28, 2023
Last updated
Feb 28, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
320800000X Community Based Residential Treatment Facility, Mental Illness––Yes
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––

Practice location

9046 S Justine St Apt 2
Chicago, IL 60620-5033

Phone 773-304-6999

Mailing address

5113 S Harper Ave Ste 2c
Chicago, IL 60615-4119

Authorized official

Chiquita Lee
Ceo/Founder
7733043699

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