| Youth Organizations Umbrella | |
|
1027 Sherman Ave Evanston IL 60202-6500 | |
| (847) 866-1200 | |
| (847) 866-9143 |
| Full Name | Youth Organizations Umbrella |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1027 Sherman Ave, Evanston, Illinois |
| Authorized Official Name and Position | Donald A. Baker (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8478661200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth Organizations Umbrella 1027 Sherman Ave Evanston IL 60202-6500 Ph: (847) 866-1200 | Youth Organizations Umbrella 1027 Sherman Ave Evanston IL 60202-6500 Ph: (847) 866-1200 |
| NPI Number | 1790018067 |
|---|---|
| Provider Enumeration Date | 09/17/2009 |
| Last Update Date | 09/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790018067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 060673-10 (Illinois) | Primary |
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