Organization
ENGLEWOOD COMMUNITY OUTREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTA COPPAGE (EXECUTIVE DIRECTOR)
(872) 209-1298
Entity
Organization
Contact information
Practice address
8848 S LANGLEY AVE, CHICAGO, IL 60619-6859
(872) 209-1298
Mailing address
9631 S CICERO AVE # 1356, OAK LAWN, IL 60453-3137
(872) 203-1298
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/05/2024
Last updated
01/05/2024
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