Organization
ENGLEWOOD COMMUNITY OUTREACH
Active
Other names
Englewood Community Outreach
Organization subpart
Yes
Provider details
NPI number
Authorized official
SHANTA COPPAGE (PRESIDENT)
(872) 209-1298
Entity
Organization
Contact information
Practice address
9531 S UTICA AVENUE, EVERGREEN PARK, IL 60805
(872) 209-1298
Mailing address
9631 S CICERO AVE STE 1356, OAK LAWN, IL 60453-3137
(872) 209-1298
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
08/06/2024
Last updated
08/06/2024
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