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Organization
CCLAKEVIEW CILA
Active
Organization
CCLAKEVIEW CILA
Active
Parent organization
COUNSELING CENTER OF LAKE VIEW
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNSELING CENTER OF LAKE VIEW
Authorized official
DANIEL P KANTER (CONTROLLER)
(773) 549-1102
Entity
Organization
Contact information
Practice address
732 W GRACE ST, CHICAGO, IL 60613-4114
(773) 549-5886
(773) 549-3265
Mailing address
3225 N SHEFFIELD AVE, CHICAGO, IL 60657-2210
(773) 549-5886
(773) 549-3265
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
04040
IL
Other
Enumeration date
08/27/2010
Last updated
06/28/2011
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