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1588039556
BIANCA DAVIS
HOMEWOOD, IL
NPI
1588039556
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
323P00000X Psychiatric Residential Treatment Facility
(Licence: IL 043.110334)
Enumeration Date
2015-12-02
Last Update Date
2015-12-02
Business Address
-- BIANCA DAVIS LPN
18610 MORRIS AVE
HOMEWOOD, IL 60430-3628
Phone number: 708-860-2143
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Mailing Address
-- BIANCA DAVIS LPN
18610 MORRIS AVE
HOMEWOOD, IL 60430-3628
Phone number: 708-860-2143
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