Organization
JMS BEHAVIORAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPHINE DELIRA LCSW (MANAGER)
(773) 786-2514
Entity
Organization
Contact information
Practice address
2363 N CALIFORNIA AVE, CHICAGO, IL 60647-2939
(773) 786-2514
Mailing address
PO BOX 478920, CHICAGO, IL 60647-8920
(773) 786-2514
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632842
BLUE CROSS BLUE SHIELD OF ILLINOIS
IL
Enumeration date
04/23/2008
Last updated
04/23/2008
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