Organization
GARDEN OF PRAYER YOUTH CENTER INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MALONEY LCPC (CEO, EXECUTIVE DIRECTOR)
(815) 933-2493
Entity
Organization
Contact information
Practice address
16601 E STATE ROUTE 114, MOMENCE, IL 60954-3812
(815) 933-2493
Mailing address
657 E COURT ST STE 200, KANKAKEE, IL 60901-4071
(815) 933-2493
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/17/2020
Last updated
01/08/2021
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