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Organization
FUNCTIONAL SKILLS GROUP
Active
Organization
FUNCTIONAL SKILLS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINESHA DENISE JOHNSON (OWNER)
(773) 449-0859
Entity
Organization
Contact information
Practice address
7808 W COLLEGE DR STE 1NE, PALOS HEIGHTS, IL 60463-1097
(773) 449-0859
(708) 398-8155
Mailing address
7808 W COLLEGE DR STE 1NE, PALOS HEIGHTS, IL 60463-1097
(773) 449-0859
(708) 398-8155
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
Primary
—
—
172V00000X
Community Health Worker
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
10/13/2019
Last updated
03/23/2025
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