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Organization
PROVISO-LEYDEN COUNCIL FOR COMMUNITY ACTION INC
Active
Organization
PROVISO-LEYDEN COUNCIL FOR COMMUNITY ACTION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAUDETTE HARRELL (CEO)
(708) 450-3500
Entity
Organization
Contact information
Practice address
308 S 5TH AVE, MAYWOOD, IL 60153-1650
(708) 343-1275
Mailing address
411 MADISON ST, MAYWOOD, IL 60153-2136
(708) 450-3500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QM2800X
Methadone Clinic
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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