Organization
BEHAVIORAL SERVICES CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENE ISYANOV (CLINICAL SERVICES DIRECTOR)
(847) 673-8577
Entity
Organization
Contact information
Practice address
310 S GREENLEAF ST STE 205, GURNEE, IL 60031
(847) 673-8577
Mailing address
8707 SKOKIE BLVD STE 207, SKOKIE, IL 60077-2272
(847) 673-8577
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
04/25/2016
Last updated
06/20/2018
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