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General NPI Number Information
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NPI Number | 1023102712
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Entity Type | Organization
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Legal Business Name | LEYDEN FAMILY SERVICE & MENTAL HEALTH CENTER
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4600 N. HARLEM
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City | HARWOOD HEIGHTS
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State | IL
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Zip | 60706
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Country | US
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Telephone | 708-867-6886
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 N. HARLEM
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City | HARWOOD HEIGHTS
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State | IL
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Zip | 60706
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Country | US
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Telephone | 708-867-6886
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MRS. DOONA CHIARIELLO SANTORO
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Credential | MSW, LCSW
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Telephone | 847-843-4919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 04089
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License Number State | IL
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