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Organization

SANCTUARY COMMUNITY COUNSELING AND RESOURCES, NFP

Active
Parent organization
SANCTUARY COUNSELING, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
SANCTUARY COUNSELING, LLC
Authorized official
DR. ROY C REESE JR. (PRESIDENT CFO)
(773) 717-9921
Entity
Organization

Contact information

Practice address
12247 S RACINE AVE, CALUMET PARK, IL 60643-5401
(312) 687-0198
Mailing address
12247 S RACINE AVE, CALUMET PARK, IL 60643-5401
(312) 687-0198

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
251S00000X
Community/Behavioral Health Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
282J00000X
Religious Nonmedical Health Care Institution

Other

Enumeration date
03/05/2020
Last updated
03/05/2020
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