Organization
LE PENSEUR YOUTH & FAMILY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REGINALD SUMMERRISE (CEO/PRESIDENT)
(773) 375-8637
Entity
Organization
Contact information
Practice address
1464 W 115TH ST, CHICAGO, IL 60643-4465
(773) 778-4980
(773) 778-4988
Mailing address
8550 S MANISTEE AVE, CHICAGO, IL 60617-3152
(773) 375-8637
(773) 375-8637
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A82510003A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
C/A82510003A
—
IL
Enumeration date
02/06/2017
Last updated
02/06/2017
Update your record
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