| NPI | 1457539223 |
|---|---|
| Doing Business As | PROVISO LEYDEN COUNCIL FOR COMMUNITY ACTION |
| Entity Type | Organization |
| Authorized Contact | CLAUDE PORTER Pastor 708-450-3506 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 0-577-0183-P) |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2008-04-20 |