Organization
DIVERSIFIED BEHAVIORAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE E. SMITH (CEO/PRESIDENT)
(773) 239-9700
Entity
Organization
Contact information
Practice address
11070 S WESTERN AVE, CHICAGO, IL 60643-3928
(773) 239-9700
(773) 239-7506
Mailing address
11070 S WESTERN AVE, CHICAGO, IL 60643-3928
(773) 239-9700
(773) 239-7506
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
12/04/2008
Last updated
12/04/2008
Update your record
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