Organization
ICAN DREAM CENTER NFP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVISHA FORD LCSW (DIRECTOR)
(708) 307-0440
Entity
Organization
Contact information
Practice address
17512 E CARRIAGEWAY DR, HAZEL CREST, IL 60429-2091
(708) 798-4200
Mailing address
17512 E CARRIAGEWAY DR, HAZEL CREST, IL 60429-2091
(708) 798-4200
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/26/2018
Last updated
04/26/2018
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