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General NPI Number Information
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NPI Number | 1255508941
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Entity Type | Organization
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Legal Business Name | ENHANCED CLINICAL SOLUTIONS, INC
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 06/21/2016
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Provider Practice Location Address
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Address Line | 1701 S 1ST AVE SUITE# 310
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City | MAYWOOD
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State | IL
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Zip | 60153-2442
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Country | US
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Telephone | 708-344-0884
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Fax | 708-343-5629
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Provider Business Mailing Address
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Address Line | 1701 S 1ST AVE
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City | MAYWOOD
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State | IL
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Zip | 60153-2442
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Country | US
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Telephone | 708-344-0884
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Fax | 708-343-5629
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FRANK MICHAEL JORDAN
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Credential |
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Telephone | 708-344-0884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | A-4749-0001-A
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | A-4749-0001-A
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License Number State | IL
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