Organization Name: | JOURNEY FOR HEALTHIER LIVING |
NPI Number: | 1891116158 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FELICIA LYNETTE NICHOLS (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 309 W 146th St Dolton |
State: | IL US |
Postal Code: | 604191410 |
Phone Number: | 7733861399 |
Fax Number: | |
NPI Enumeration Date: | 01/03/2014 |
NPI Last Update Date: | 01/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |