Ican Dream Center Nfp
NPI #1114415080 in Hazel Crest, Illinois
Provider Information
- NPI Number
- 1114415080
- Entity Type
- Organization
- Organization Name
- Ican Dream Center Nfp
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Apr 26, 2018
- Last Updated
- Apr 26, 2018
Practice Location
- Address
- 17512 E CARRIAGEWAY DR
- City
- Hazel Crest
- State
- Illinois
- ZIP Code
- 60429-2091
- Phone
- (708) 798-4200
Authorized Official
- Name
- DR. EVISHA FORD, LCSW
- Title
- DIRECTOR
- Phone
- (708) 307-0440
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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