Organization Name: | MELI DEVELOPMENT CENTER |
NPI Number: | 1063565190 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MELISA ALABA-YUSOUF (DIRECTOR) |
Mailing Address: | 542 E Boughton Rd Bolingbrook |
State: | IL US |
Postal Code: | 604402181 |
Phone Number: | 6307831850 |
Fax Number: | |
NPI Enumeration Date: | 01/20/2007 |
NPI Last Update Date: | 05/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 180006045 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |