Organization
LOYOLA UNIVERSITY SCHOOL OF NURSING - SCHOOL-BASED HEALTH CENTER
Active
Parent organization
LOYOLA UNIVERSITY HEALTH SYSTEM
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOYOLA UNIVERSITY HEALTH SYSTEM
Authorized official
DR. DIANA P. HACKBARTH PHD, RN, FAAN (PROJECT DIRECTOR: LOYOLA UNIVERSITY)
(708) 216-3670
Entity
Organization
Contact information
Practice address
807 SOUTH FIRST AVENUE, SCHOOL-BASED HEALTH CENTER AT PROVISO EAST HIGH SCHOOL, MAYWOOD, IL 60153
(708) 449-9522
(708) 449-9525
Mailing address
2160 SOUTH FIRST AVENUE, MAGUIRE - 105-2840, MAYWOOD, IL 60153
(708) 449-9522
(708) 449-9525
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/18/2009
Last updated
12/18/2009
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