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Organization
B.O.O.C. INC.
Active
Organization
B.O.O.C. INC.
Active
Other names
Building Our Own Community
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE L DAVIS (PRESIDENT - CEO)
(708) 849-3237
Entity
Organization
Contact information
Practice address
15475 S PARK AVE STE 101, SOUTH HOLLAND, IL 60473-1378
(312) 818-8120
Mailing address
15475 S PARK AVE STE 101, SOUTH HOLLAND, IL 60473-1378
(312) 818-8120
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YP1600X
Pastoral Counselor
—
—
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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