Organization
DEBORAH'S PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHARINE C BOOTON WILSON LCSW (CHIEF STRATEGY OFFICER)
(773) 638-6392
Entity
Organization
Contact information
Practice address
2822 W JACKSON BLVD, CHICAGO, IL 60612-3653
(773) 722-5080
Mailing address
1530 N SEDGWICK ST, CHICAGO, IL 60610-5853
(312) 944-9227
(312) 944-1398
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
149,015965
IL
251B00000X
Case Management Agency
149.007559
IL
251B00000X
Case Management Agency
149.011208
IL
251B00000X
Case Management Agency
149.016615
IL
251B00000X
Case Management Agency
150.015350
IL
251S00000X
Community/Behavioral Health Agency
Primary
149.007559
IL
251S00000X
Community/Behavioral Health Agency
149.011208
IL
251S00000X
Community/Behavioral Health Agency
149.015965
IL
251S00000X
Community/Behavioral Health Agency
149.016615
IL
251S00000X
Community/Behavioral Health Agency
150.015350
IL
Other
Enumeration date
01/11/2016
Last updated
01/11/2016
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