Healthcare Provider Details

I. General information

NPI: 1407331077
Provider Name (Legal Business Name): LINK AND OPTION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2018
Last Update Date: 10/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 W 177TH ST STE 2C
HAZEL CREST IL
60429-2186
US

IV. Provider business mailing address

900 E 162ND ST STE 102
SOUTH HOLLAND IL
60473-2477
US

V. Phone/Fax

Practice location:
  • Phone: 708-331-8111
  • Fax: 708-331-8088
Mailing address:
  • Phone: 708-331-8111
  • Fax: 708-331-8088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TWIN DENISE GREEN
Title or Position: PRESIDENT & CEO
Credential:
Phone: 708-331-8111