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Organization
CHILDHOOD TRAUMA TREATMENT PROGRAM OF ADVOCATE HEALTH & HOSPITALS CORP
Active
Organization
CHILDHOOD TRAUMA TREATMENT PROGRAM OF ADVOCATE HEALTH & HOSPITALS CORP
Active
Parent organization
FAMILY CARE NETWORK OF ADVOCATE HEALTH & HOSPITALS CORP.
Other names
Childhood Trauma Treatment Program
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY CARE NETWORK OF ADVOCATE HEALTH & HOSPITALS CORP.
Authorized official
DR. GENE S. CARROCCIA PSY.D. (CLINICAL DIRECTOR)
(800) 216-1110
Entity
Organization
Contact information
Practice address
4700 W 95TH ST, LL5, OAK LAWN, IL 60453-2533
(800) 216-1110
(708) 346-4868
Mailing address
PO BOX 776, CHILDHOOD TRAUMA TREATMENT PROGRAM, OAK LAWN, IL 60454-0776
(800) 216-1110
(708) 346-4868
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/07/2010
Last updated
04/07/2010
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