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General NPI Number Information
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NPI Number | 1700498573
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Entity Type | Organization
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Legal Business Name | BOBBY E. WRIGHT COMPREHENSIVE BEHAVIORAL HEALTH CENTER, INC.
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Dates
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Enumeration Date | 08/21/2020
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 5816 W DIVISION ST FL 1
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City | CHICAGO
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State | IL
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Zip | 60651-1003
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Country | US
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Telephone | 773-722-7900
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Fax | 773-722-0644
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Provider Business Mailing Address
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Address Line | 5090 W HARRISON ST
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City | CHICAGO
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State | IL
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Zip | 60644-5141
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Country | US
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Telephone | 773-722-7900
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Fax | 773-722-0644
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | KELLI PERKINS
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Credential | CTP
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Telephone | 773-722-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #5
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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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Taxonomy #6
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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 |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #8
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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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