Healthcare Provider Details

I. General information

NPI: 1528531639
Provider Name (Legal Business Name): REESTABLISHING HOPE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17577 KEDZIE AVE
HAZEL CREST IL
60429-2051
US

IV. Provider business mailing address

3850 DEWEY AVE
RICHTON PARK IL
60471-2563
US

V. Phone/Fax

Practice location:
  • Phone: 815-418-6577
  • Fax:
Mailing address:
  • Phone: 815-418-6577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARY A CAMPER
Title or Position: CEO
Credential: DD, PSYD, LCSW, CADC
Phone: 815-418-6577