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NPI Code Detail

MEDICARE: BOBBY E WRIGHT COMPREHENSIVE BEHAVIORAL HEALTH CENTER INC.

MEDICARE: BOBBY E WRIGHT COMPREHENSIVE BEHAVIORAL HEALTH CENTER INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management AgencyIL
2251S00000XCommunity/Behavioral Health AgencyIL
3261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
4320800000XMental Illness Community Based Residential Treatment Facility
5261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1588832786
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOBBY E WRIGHT COMPREHENSIVE BEHAVIORAL HEALTH CENTER INC.
Provider Business Mailing Address
First Line : 5090 W HARRISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60644-5141
Country : US
Telephone Number : 773-722-7900
Fax Number : 773-722-0644
Provider Business Practice Location Address
First Line : 5002 W MADISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60644-4127
Country : US
Telephone Number : 773-722-7900
Fax Number : 773-722-0644
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : KELLI PERKINS
Credential : CTP
Telephone Number : 773-722-7900
Provider Enumeration Date : 02/11/2008
Last Update Date : 02/21/2025

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