Organization
KEY TO HOPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JORDAIN JACKSON (ABA LINE THERAPIST)
(312) 218-2671
Entity
Organization
Contact information
Practice address
1593 GREEN BAY RD, HIGHLAND PARK, IL 60035-3601
(312) 218-2671
Mailing address
1593 GREEN BAY RD, HIGHLAND PARK, IL 60035-3601
(312) 218-2671
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/31/2013
Last updated
03/31/2013
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