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Organization

CHICAGO MENTAL AND LIFE WELLBEING INSTITUTE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TANISHA HINES (ADMINISTRATOR)
(773) 569-0791
Entity
Organization

Contact information

Practice address
8547 S STONY ISLAND AVE, CHICAGO, IL 60617-2249
(773) 569-0791
Mailing address
3817 W 85TH PL, CHICAGO, IL 60652-3709
(773) 569-0791

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
11/07/2022
Last updated
11/15/2022
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