Organization
PROJECT180-CHICAGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSALYN YOUNG (CEO/FOUNDER)
(312) 617-7857
Entity
Organization
Contact information
Practice address
1507 E 53RD ST, UNIT 247, CHICAGO, IL 60615-4573
(312) 620-2410
Mailing address
1507 E 53RD ST, UNIT 247, CHICAGO, IL 60615-4573
(312) 620-2410
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
IL
Other
Enumeration date
05/10/2017
Last updated
11/06/2023
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