| Garden Of Prayer Youth Center | |
|
101 South Division Aroma Park IL 60910-6009 | |
| (815) 933-2493 | |
| (815) 933-2494 |
| Full Name | Garden Of Prayer Youth Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 101 South Division, Aroma Park, Illinois |
| Authorized Official Name and Position | Mikkal Harris (CLINICAL DIVISION DIRECTOR) |
| Authorized Official Contact | 8159332493 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Garden Of Prayer Youth Center 657 E Court St Ste 200 Kankakee IL 60901-4071 Ph: (815) 933-2493 | Garden Of Prayer Youth Center 101 South Division Aroma Park IL 60910-6009 Ph: (815) 933-2493 |
| NPI Number | 1699358051 |
|---|---|
| Provider Enumeration Date | 05/04/2021 |
| Last Update Date | 05/04/2021 |
| Certification Date | 05/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699358051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |