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NPI Code Detail

MEDICARE: THE BRANCH FAMILY INSTITUTE, INC.

MEDICARE: THE BRANCH FAMILY INSTITUTE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251V00000XVoluntary or Charitable AgencyIL

General Provider Information

NPI Number : 1366880429
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE BRANCH FAMILY INSTITUTE, INC.
Provider Business Mailing Address
First Line : 11111 S WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60643-3907
Country : US
Telephone Number : 773-238-1100
Fax Number : 773-238-4095
Provider Business Practice Location Address
First Line : 11111 S WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60643-3907
Country : US
Telephone Number : 773-238-1100
Fax Number : 773-238-4095
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : MRS. NIKIA S THOMPSON
Credential : LCSW
Telephone Number : 773-238-1100
Provider Enumeration Date : 06/11/2013
Last Update Date : 06/11/2013

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Directions to “THE BRANCH FAMILY INSTITUTE, INC. ” Practice Location

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