Provider Demographics
NPI:1629681093
Name:HEALING HANDS RESOURCE CENTER
Entity Type:Organization
Organization Name:HEALING HANDS RESOURCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/EXEC DIRECTOR
Authorized Official - Prefix:
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:773-572-9551
Practice Address - Street 1:2128 S CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-3113
Practice Address - Country:US
Practice Address - Phone:773-467-6967
Practice Address - Fax:773-572-9551
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALING HANDS RESOURCE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty