Organization
HOLISTIC COMMUNITY OUTREACH CENTER INC.
Active
Other names
Fountain of Life
Organization subpart
No
Provider details
NPI number
Authorized official
THELMA JEAN CONNER RN (ADMINISTRATOR)
(773) 434-6370
Entity
Organization
Contact information
Practice address
8100 S WESTERN AVE, CHICAGO, IL 60620-5937
(773) 434-6070
(773) 434-6382
Mailing address
8100 S WESTERN AVE, CHICAGO, IL 60620-5937
(773) 434-6070
(773) 434-6382
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
Other
Enumeration date
07/09/2012
Last updated
08/08/2022
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