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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