Organization
ILLINOIS YOUTH ADVOCATE PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD M. FARMER M.A. (EXECUTIVE DIRECTOR)
(708) 596-6955
Entity
Organization
Contact information
Practice address
191 W 155TH PL, HARVEY, IL 60426-3413
(708) 596-6955
(708) 596-7464
Mailing address
191 W 155TH PL, HARVEY, IL 60426-3413
(708) 596-6955
(708) 596-7464
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
338374-06
IL
Other
Enumeration date
11/06/2006
Last updated
08/22/2020
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