Organization
MYSI CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TOLEDA HART (PRESIDENT/CEO)
(773) 840-4600
Entity
Organization
Contact information
Practice address
3001 W 111TH ST, SUITE 103, CHICAGO, IL 60655-2240
(773) 840-4600
(773) 840-4605
Mailing address
3001 W 111TH ST, SUITE 103, CHICAGO, IL 60655-2240
(773) 840-4600
(773) 840-4605
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
201400011C
IL
Other
Enumeration date
01/15/2016
Last updated
01/15/2016
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