Organization
GOOD VIBES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DAVIS (OWNER)
(773) 301-6754
Entity
Organization
Contact information
Practice address
18050 MICHAEL AVE, COUNTRY CLUB HILLS, IL 60478-5022
(773) 301-6754
Mailing address
18050 MICHAEL AVE, COUNTRY CLUB HILLS, IL 60478-5022
(773) 301-6754
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/27/2021
Last updated
10/05/2021
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