Organization
NIA'S HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARLENA CLARK PHD (CEO)
(630) 660-5507
Entity
Organization
Contact information
Practice address
515 E 44TH ST APT 1, CHICAGO, IL 60653-4748
(630) 660-5507
Mailing address
515 E 44TH ST APT 1, CHICAGO, IL 60653-4748
(630) 660-5507
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/10/2020
Last updated
10/31/2020
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