Organization
UNIVERSAL FAMILY CONNECTION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY HARRIS PSY.D. (CHIEF OPERATING OFFICER)
(773) 881-1711
Entity
Organization
Contact information
Practice address
1350 W 103RD ST, CHICAGO, IL 60643-2302
(773) 881-1711
(773) 881-3124
Mailing address
1350 W 103RD ST, CHICAGO, IL 60643-2302
(773) 881-1711
(773) 881-3124
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A794900001A
—
IL
Enumeration date
08/28/2019
Last updated
01/05/2021
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