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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