Organization
PROVISO LEYDEN COUNCIL FOR COMMUNITY ACTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EVELYN JOY COKER L.C.S.W. (DIR. OF CLINICAL & SOCIAL SERVICES)
(708) 450-3500
Entity
Organization
Contact information
Practice address
411 MADISON ST, MAYWOOD, IL 60153-2136
(708) 450-3500
(708) 236-5189
Mailing address
411 MADISON ST, PO BOX 950, MAYWOOD, IL 60153-2136
(708) 450-3500
(708) 236-5189
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
IL
Other
Enumeration date
08/08/2011
Last updated
08/08/2011
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