Organization
MANNA FOR LIFE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REGINA B MCCLURE LCPC (MANAGER)
(312) 834-3689
Entity
Organization
Contact information
Practice address
17541 KEDZIE AVE, #346, HAZEL CREST, IL 60429-2061
(312) 834-3689
(708) 798-9883
Mailing address
17541 KEDZIE AVE, #346, HAZEL CREST, IL 60429-2061
(312) 834-3689
(708) 798-9883
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
180006074
IL
Other
Enumeration date
03/31/2008
Last updated
08/17/2011
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