Organization
A BEAUTIFUL MIND, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHIQUITA LEE (CEO/FOUNDER)
(773) 304-3699
Entity
Organization
Contact information
Practice address
9046 S JUSTINE ST APT 2, CHICAGO, IL 60620-5033
(773) 304-6999
Mailing address
5113 S HARPER AVE STE 2C, CHICAGO, IL 60615-4119
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000
N/A
—
01
—
0000
N/A
—
Enumeration date
10/29/2020
Last updated
02/28/2023
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