Organization
NEW DIRECTION OUTREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN JEROME LAFLORA M.S. (EXECUTIVE DIRECTOR)
(773) 483-2226
Entity
Organization
Contact information
Practice address
6857 S STATE ST, CHICAGO, IL 60637-3910
(773) 483-2226
(773) 224-8201
Mailing address
6857 S STATE ST, CHICAGO, IL 60637-3910
(773) 483-2226
(773) 224-8201
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2B05-CHR-096
—
IL
Enumeration date
05/23/2006
Last updated
08/22/2020
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