Organization
ONE DIRECTION FORWARD INC.
Active
Organization
ONE DIRECTION FORWARD INC.
Active
Other names
One Direction Forward Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH SIMPSON SR. LCSW (CEO)
(708) 300-6977
Entity
Organization
Contact information
Practice address
4747 LINCOLN MALL DR STE 412, MATTESON, IL 60443-3821
(708) 300-6977
(708) 300-6978
Mailing address
4747 LINCOLN MALL DR STE 412, MATTESON, IL 60443-3821
(708) 300-6977
(708) 300-6978
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215392931
—
IL
Enumeration date
05/10/2022
Last updated
05/10/2022
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