| Shades Of Hope Llc | |
|
15941 Harlem Ave 126 Tinley Park IL 60477-1609 | |
| (773) 858-3106 | |
| Not Available |
| Full Name | Shades Of Hope Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 15941 Harlem Ave, Tinley Park, Illinois |
| Authorized Official Name and Position | Akilah Baker (CEO) |
| Authorized Official Contact | 7738583106 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shades Of Hope Llc 15941 Harlem Ave 126 Tinley Park IL 60477-1609 Ph: () - | Shades Of Hope Llc 15941 Harlem Ave 126 Tinley Park IL 60477-1609 Ph: (773) 858-3106 |
| NPI Number | 1619301066 |
|---|---|
| Provider Enumeration Date | 08/21/2013 |
| Last Update Date | 10/16/2013 |
| Medicare PECOS PAC ID | 8628202215 |
|---|---|
| Medicare Enrollment ID | O20131015001061 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619301066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 149.015481 (Illinois) | Primary |
| Provider Name | Akilah A Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497007272 PECOS PAC ID: 4880848209 Enrollment ID: I20130211000469 |
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