Organization
GARDEN OF PRAYER YOUTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL A MALONEY LCPC (EXECUTIVE DIRECTOR)
(815) 933-2493
Entity
Organization
Contact information
Practice address
1432 S 4TH AVE, KANKAKEE, IL 60901-4931
(815) 933-2493
(815) 933-2494
Mailing address
657 E COURT ST, SUITE 200, KANKAKEE, IL 60901-4055
(815) 933-2493
(815) 933-2494
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
IL
251S00000X
Community/Behavioral Health Agency
Primary
442707
IL
Other
Enumeration date
10/17/2014
Last updated
10/21/2014
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