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General NPI Number Information
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NPI Number | 1700894979
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Entity Type | Organization
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Legal Business Name | I AM ABLE CENTER FOR FAMILY DEVELOPMENT, INC.
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 3410 W ROOSEVELT RD
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City | CHICAGO
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State | IL
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Zip | 60624-4343
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Country | US
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Telephone | 773-826-2929
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Fax | 773-826-2964
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Provider Business Mailing Address
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Address Line | 3410 WEST ROOSEVELT ROAD
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City | CHICAGO
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State | IL
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Zip | 60624-4343
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Country | US
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Telephone | 773-826-2929
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Fax | 773-826-2964
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. CAROLYN L. VESSEL
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Credential | BA, MSHSA, M-DIV.,DD
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Telephone | 773-840-8061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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