| Youth Crossroads, Inc. | |
|
6501 Stanley Ave Berwyn IL 60402-3123 | |
| (708) 484-7400 | |
| Not Available |
| Full Name | Youth Crossroads, Inc. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 6501 Stanley Ave, Berwyn, Illinois |
| Authorized Official Name and Position | Josephine Dicesare (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7084847400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Crossroads, Inc. 6501 Stanley Ave Berwyn IL 60402-3123 Ph: (708) 484-7400 | Youth Crossroads, Inc. 6501 Stanley Ave Berwyn IL 60402-3123 Ph: (708) 484-7400 |
| NPI Number | 1629778550 |
|---|---|
| Provider Enumeration Date | 03/08/2023 |
| Last Update Date | 03/08/2023 |
| Certification Date | 03/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629778550 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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