Organization
BEVERLY GROUP MHS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LATRICE FOULES MSW (COUNSELOR)
(708) 906-7912
Entity
Organization
Contact information
Practice address
53 W JACKSON BLVD, SUITE 1705, CHICAGO, IL 60604-3606
(773) 490-0576
Mailing address
4444 S BERKELEY AVE, CHICAGO, IL 60653-3610
(773) 490-0576
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.010964
IL
Other
Enumeration date
05/07/2010
Last updated
05/07/2010
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