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General NPI Number Information
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NPI Number | 1073262044
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Entity Type | Organization
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Legal Business Name | AGENTS OF HOPE TRAINING& INFORMATION CENTER
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Dates
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Enumeration Date | 03/18/2022
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 2046 W DEVON AVE
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City | CHICAGO
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State | IL
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Zip | 60659-2241
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Country | US
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Telephone | 773-739-9079
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Fax | 773-739-9080
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Provider Business Mailing Address
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Address Line | 2046 W DEVON AVE
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City | CHICAGO
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State | IL
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Zip | 60659-2241
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Country | US
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Telephone | 773-739-9079
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Fax | 773-739-9080
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. HODAN A AHMED
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Credential |
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Telephone | 773-943-1172
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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 |
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License Number State |
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