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General NPI Number Information
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NPI Number | 1366629685
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Entity Type | Organization
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Legal Business Name | AUSTIN ADULT MENTAL HEALTH, YMCA
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 501 N CENTRAL AVE
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City | CHICAGO
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State | IL
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Zip | 60644-1509
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Country | US
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Telephone | 773-287-9120
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Fax |
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Provider Business Mailing Address
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Address Line | 501 N CENTRAL AVE
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City | CHICAGO
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State | IL
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Zip | 60644-1509
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Country | US
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Telephone | 773-287-9120
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. ERIC CRAWFORD
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Credential | L.P.C
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Telephone | 773-287-9120
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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 |
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