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General NPI Number Information
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NPI Number | 1407244874
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Entity Type | Organization
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Legal Business Name | COMMUNITY LINKS OF CHICAGO INC
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Dates
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Enumeration Date | 01/07/2015
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Last Update Date | 01/07/2015
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Provider Practice Location Address
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Address Line | 4037 W GLADYS AVE
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City | CHICAGO
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State | IL
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Zip | 60624-2708
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Country | US
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Telephone | 773-425-1760
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Fax |
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Provider Business Mailing Address
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Address Line | 4037 W GLADYS AVE
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City | CHICAGO
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State | IL
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Zip | 60624-2708
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Country | US
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Telephone | 773-425-1760
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. TERRI DAVIS
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Credential | LSW
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Telephone | 773-425-1760
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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 | 150.014137
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License Number State | IL
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