Provider Demographics
NPI:1619508074
Name:STAIRWAY TO GREATNESS MENTORSHIP-ENTREPRENEURSHIP PROGRAM
Entity Type:Organization
Organization Name:STAIRWAY TO GREATNESS MENTORSHIP-ENTREPRENEURSHIP PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:A
Authorized Official - Last Name:BADY
Authorized Official - Suffix:I
Authorized Official - Credentials:CADC
Authorized Official - Phone:773-703-0609
Mailing Address - Street 1:18 WELLS AVE
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:IL
Mailing Address - Zip Code:60426-1217
Mailing Address - Country:US
Mailing Address - Phone:773-703-0609
Mailing Address - Fax:
Practice Address - Street 1:18 WELLS AVE
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:IL
Practice Address - Zip Code:60426-1217
Practice Address - Country:US
Practice Address - Phone:773-703-0609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health