Organization
LANGUAGE INTEGRATED PROGRAMS AND SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DOMINIQUE JOLIE CARTER M.S. CCC-SLP (DIRECTOR OF SERVICES)
(240) 417-9810
Entity
Organization
Contact information
Practice address
6431 SOUTH GREENWOOD AVE., CHICAGO, IL 60637-3603
(240) 417-9810
Mailing address
6431 SOUTH GREENWOOD AVE., CHICAGO, IL 60637-3603
(240) 417-9810
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
146009176
IL
Other
Enumeration date
07/17/2008
Last updated
07/17/2008
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