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Organization

THE DIVERSITY OF YOUTH CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GABRIELLE TYEPTANAR (EXECUTIVE DIRECTOR)
(563) 564-0843
Entity
Organization

Contact information

Practice address
966 E 93RD ST, CHICAGO, IL 60619-7814
(563) 564-0843
Mailing address
14750 KEYSTONE AVE, MIDLOTHIAN, IL 60445-3332
(563) 564-0843

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
251S00000X
Community/Behavioral Health Agency
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center

Other

Enumeration date
01/05/2026
Last updated
02/09/2026
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