| House Of Hearts Cila Llc | |
|
2111 121st St Blue Island IL 60406-1201 | |
| (773) 597-7698 | |
| Not Available |
| Full Name | House Of Hearts Cila Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2111 121st St, Blue Island, Illinois |
| Authorized Official Name and Position | Marvin D Coklow (CFO) |
| Authorized Official Contact | 7735977698 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| House Of Hearts Cila Llc 2111 121st St Blue Island IL 60406-1201 Ph: (773) 597-7698 | House Of Hearts Cila Llc 2111 121st St Blue Island IL 60406-1201 Ph: (773) 597-7698 |
| NPI Number | 1326720145 |
|---|---|
| Provider Enumeration Date | 08/02/2023 |
| Last Update Date | 08/02/2023 |
| Certification Date | 08/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326720145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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