Provider Demographics
NPI:1477081057
Name:HOWARD INTERVENTION CENTER
Entity Type:Organization
Organization Name:HOWARD INTERVENTION CENTER
Other - Org Name:JIGSAW JUMP-START INTERVENTION CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BCBA/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:SALHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-801-1717
Mailing Address - Street 1:1265 ROSEDALE LN
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2664
Mailing Address - Country:US
Mailing Address - Phone:708-351-2676
Mailing Address - Fax:
Practice Address - Street 1:18324 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-3403
Practice Address - Country:US
Practice Address - Phone:224-801-1717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-26
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty