Healthcare Provider Details

I. General information

NPI: 1992577845
Provider Name (Legal Business Name): PEOPLE FIRST BEHAVIOR HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18241 WEST ST STE 207A
LANSING IL
60438-3282
US

IV. Provider business mailing address

18241 WEST ST STE 207A
LANSING IL
60438-3282
US

V. Phone/Fax

Practice location:
  • Phone: 702-574-9383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. LADONNA WASHINGTON
Title or Position: OWNER
Credential:
Phone: 702-574-9383