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General NPI Number Information
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NPI Number | 1730620642
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Entity Type | Organization
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Legal Business Name | HEALING HANDS RESOURCE CENTER
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Dates
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Enumeration Date | 03/10/2017
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Last Update Date | 11/25/2019
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Provider Practice Location Address
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Address Line | 400 RIVER OAKS DR
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City | CALUMET CITY
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State | IL
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Zip | 60409-5832
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Country | US
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Telephone | 773-467-6967
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Fax | 773-572-9553
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Provider Business Mailing Address
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Address Line | 1022 N KEDZIE AVE
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City | CHICAGO
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State | IL
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Zip | 60651-4128
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Country | US
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Telephone | 773-467-6967
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Fax | 773-572-9553
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Authorized Official
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Title or Position | CEO
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Name | VALENCIA GREEN
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Credential | MD, MPH
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Telephone | 773-467-6967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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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 | 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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