Organization
HOUSE OF HEARTS CILA LLC
Active
Organization
HOUSE OF HEARTS CILA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARVIN COKLOW (CFO)
(773) 597-7698
Entity
Organization
Contact information
Practice address
2111 121ST ST, BLUE ISLAND, IL 60406-1201
(773) 499-4062
Mailing address
2111 121ST ST, BLUE ISLAND, IL 60406-1201
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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