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General NPI Number Information
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NPI Number | 1790373702
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Entity Type | Organization
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Legal Business Name | UNIVERSAL FAMILY CONNECTION, INC.
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Dates
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Enumeration Date | 01/05/2021
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 7949 S WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60620-5941
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Country | US
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Telephone | 773-925-0900
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Fax | 773-925-7215
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Provider Business Mailing Address
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Address Line | 1350 W 103RD ST
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City | CHICAGO
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State | IL
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Zip | 60643-2302
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Country | US
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Telephone | 773-881-1711
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Fax | 773-881-3124
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARY JO BAYER
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Credential |
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Telephone | 773-881-1711
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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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