Provider Demographics
NPI:1053921296
Name:HEALING HANDS RESOURCE CENTER
Entity type:Organization
Organization Name:HEALING HANDS RESOURCE CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VALENCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:773-467-6967
Mailing Address - Street 1:1022 N KEDZIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651-4128
Mailing Address - Country:US
Mailing Address - Phone:773-467-6967
Mailing Address - Fax:773-572-9553
Practice Address - Street 1:6607 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62223-3025
Practice Address - Country:US
Practice Address - Phone:773-467-6967
Practice Address - Fax:773-572-9553
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALING HANDS RESOURCE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-03
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty