Organization
THE METRO MENTORSHIP INITIATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORNE MASSIE (PRESIDENT)
(773) 595-4645
Entity
Organization
Contact information
Practice address
1828 N LOWELL AVE, CHICAGO, IL 60639-4818
(773) 595-4645
Mailing address
1828 N LOWELL AVE, CHICAGO, IL 60639-4818
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
03/29/2016
Last updated
03/29/2016
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