Organization
SOLID GROUND FOUNDATION FOR BEHAVIORAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INONGE L. MASON (PRESIDENT)
(708) 969-4109
Entity
Organization
Contact information
Practice address
2033 198TH STREET, LYNWOOD, IL 60411-6080
(708) 969-4109
Mailing address
11940 S SPRINGFIELD AVE, ALSIP, IL 60803-1117
(708) 480-2475
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
09/30/2020
Last updated
09/30/2020
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