Organization
BOBBY E WRIGHT CCMHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMONE EDWARDS (CFO)
(773) 722-7900
Entity
Organization
Contact information
Practice address
3525 W JACKSON BLVD, CHICAGO, IL 60624-3255
(773) 722-7900
(773) 722-0644
Mailing address
5002 W MADISON ST, CHICAGO, IL 60644-4127
(773) 722-7900
(773) 722-0644
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
IL
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
02/11/2008
Last updated
08/21/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us