Provider Demographics
NPI:1689971764
Name:HALFWAY HOUSE COMMITTEE, INC.
Entity Type:Organization
Organization Name:HALFWAY HOUSE COMMITTEE, INC.
Other - Org Name:SADIE WATERFORD ASSESSMENT & THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:P
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:708-371-1969
Mailing Address - Street 1:13651 S CRAWFORD AVE
Mailing Address - Street 2:
Mailing Address - City:ROBBINS
Mailing Address - State:IL
Mailing Address - Zip Code:60472-1437
Mailing Address - Country:US
Mailing Address - Phone:708-371-1969
Mailing Address - Fax:708-371-1204
Practice Address - Street 1:174 E 154TH ST STE 200
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:IL
Practice Address - Zip Code:60426-3327
Practice Address - Country:US
Practice Address - Phone:708-339-0040
Practice Address - Fax:708-339-0290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149011346101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty