NPI 1205001914

Mobi-Dent P.C.

Organisation Physical Disabilities Residential Treatment Facility Flossmoor, IL

Practice location

Address: 1719 Heather Hill Cres, Flossmoor, IL 60422-2041
Phone: (708) 228-0474
Fax: (314) 837-8918
Mailing address: 15652 94th Ave, Florissant, MO 63034-2175

Authorised official

Name: Avery Cortez Powell
Title: President
Phone: (708) 228-0474

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence 019022452 (IL)

Other Residential Treatment Facility, Physical Disabilities providers in Illinois →

Registry record

NPI: 1205001914
Entity type: Organization
NPI issued: 23 Apr 2008
Record last updated: 23 Apr 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.