NPI 1649548405

Supported Independence

Organisation Community/Behavioral Health Agency Hazel Crest, IL

Practice location

Address: 17009 Elm Drive, Hazel Crest, IL 60429
Phone: (630) 667-7370
Mailing address: 17900 Elm Drive, Hazel Crest, IL 60429

Authorised official

Name: Jessica Luckett
Title: President
Phone: (630) 667-7370

Registered specialties

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X

Other Community/Behavioral Health providers in Illinois →

Registry record

NPI: 1649548405
Entity type: Organization
NPI issued: 8 Dec 2011
Record last updated: 8 Dec 2011

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.