| Organization Name: | RESURRECTION BEHAVIORAL HEALTH |
| NPI Number: | 1083978324 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONALD PINKSTON (MANAGER) |
| Mailing Address: | 1414 Main St Melrose Park |
| State: | IL US |
| Postal Code: | 601603902 |
| Phone Number: | 7086810073 |
| Fax Number: | 7086813958 |
| NPI Enumeration Date: | 07/02/2012 |
| NPI Last Update Date: | 07/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | 178.007422 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |