Organization
JBL GROUP
Active
Other names
Midway Community Center
Organization subpart
No
Provider details
NPI number
Authorized official
GERTHA WELLS (CEO)
(708) 574-4764
Entity
Organization
Contact information
Practice address
2 W 103RD ST, CHICAGO, IL 60628-2619
(312) 489-4715
Mailing address
2 W 103RD ST, CHICAGO, IL 60628-2619
(312) 489-4715
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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