| NPI | 1023442753 |
|---|---|
| Doing Business As | PROVISO LEYDEN COUNCIL FOR COMMUNITY ACTION, INC. |
| Entity Type | Organization |
| Authorized Contact | PAMELA M YATES Data/Billing Specialist 708-450-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2022-08-05 |