Organization
PROVISO-LEYDEN COUNCIL FOR COMMUNITY ACTION INC
Active
Organization
PROVISO-LEYDEN COUNCIL FOR COMMUNITY ACTION INC
Active
Other names
PLCCA
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB ALOOR MATHEW (BOARD MEMBER)
(708) 632-5610
Entity
Organization
Contact information
Practice address
411 MADISON ST, MAYWOOD, IL 60153-2136
(708) 450-3500
(708) 236-5184
Mailing address
411 MADISON ST, MAYWOOD, IL 60153-2136
(708) 450-3500
(708) 236-5184
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
12/11/2024
Last updated
04/21/2026
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