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Organization
BOBBY E WRIGHT COMPREHENSIVE BEHAVIORAL HEALTH CENTER INC.
Active
Organization
BOBBY E WRIGHT COMPREHENSIVE BEHAVIORAL HEALTH CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEMETRIUS STUBBS (DIRECTOR OF REVENUE CYCLE)
(773) 722-7900
Entity
Organization
Contact information
Practice address
5090 W HARRISON ST, CHICAGO, IL 60644-5141
(773) 722-7900
Mailing address
5090 W HARRISON ST, CHICAGO, IL 60644-5141
(773) 722-7900
(773) 722-0644
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
695850
MEDICARE PIN
IL
01
—
IL7164
MEDICARE PIN
IL
01
—
IL7164001
MEDICARE
IL
Enumeration date
08/27/2020
Last updated
02/26/2026
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