Organization
RESURRECTION BEHAVIORAL HEALTH
Active
Other names
Proviso Family Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD PINKSTON LCSW (MANAGER)
(708) 681-0073
Entity
Organization
Contact information
Practice address
1414 MAIN ST, MELROSE PARK, IL 60160-3902
(708) 681-0073
(708) 681-3958
Mailing address
1414 MAIN ST, MELROSE PARK, IL 60160-3902
(708) 681-0073
(708) 681-3958
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
178.007422
IL
Other
Enumeration date
07/02/2012
Last updated
07/02/2012
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