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General NPI Number Information
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NPI Number | 1295012193
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Entity Type | Organization
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Legal Business Name | CRISIS INTERVENTION THROUGH CHRIST
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Dates
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Enumeration Date | 11/07/2011
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Last Update Date | 11/07/2011
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Provider Practice Location Address
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Address Line | 9964 S WINSTON AVE
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City | CHICAGO
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State | IL
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Zip | 60643-1326
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Country | US
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Telephone | 888-242-2971
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Fax | 888-242-2971
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Provider Business Mailing Address
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Address Line | 9964 S WINSTON AVE
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City | CHICAGO
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State | IL
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Zip | 60643-1326
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Country | US
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Telephone | 888-242-2971
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Fax | 888-242-2971
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HIRAM JERMAINE WHITE
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Credential |
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Telephone | 888-242-2971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | IL
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