Provider Demographics
NPI:1124594551
Name:THE CENTRE OF INFINITE POSSIBILITIES
Entity Type:Organization
Organization Name:THE CENTRE OF INFINITE POSSIBILITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEVELOPMENTAL THERAPIST/PARENT EDUC
Authorized Official - Prefix:
Authorized Official - First Name:COLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GATLING-MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:773-230-2304
Mailing Address - Street 1:PO BOX 7723
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60680-7723
Mailing Address - Country:US
Mailing Address - Phone:773-230-2304
Mailing Address - Fax:888-974-1473
Practice Address - Street 1:2324 W JACKSON BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-2913
Practice Address - Country:US
Practice Address - Phone:773-230-2304
Practice Address - Fax:888-974-1473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty