Healthcare Provider Details

I. General information

NPI: 1588866974
Provider Name (Legal Business Name): ECNERET FAMILY SERVICES - NFP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15957 HALSTED ST
HARVEY IL
60426-5222
US

IV. Provider business mailing address

4998 WEST HAWK LANE
MONEE IL
60449
US

V. Phone/Fax

Practice location:
  • Phone: 877-221-7036
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. TERENCE MAURICE BROWN
Title or Position: CEO
Credential: PH.D.
Phone: 708-351-5000