Provider Demographics
NPI:1760892574
Name:KNEW EXPECTATIONS AND ASSOCIATES,INC.
Entity Type:Organization
Organization Name:KNEW EXPECTATIONS AND ASSOCIATES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MORA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPICER
Authorized Official - Suffix:II
Authorized Official - Credentials:MSW, CADC
Authorized Official - Phone:404-720-4056
Mailing Address - Street 1:12520 S STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60628-7231
Mailing Address - Country:US
Mailing Address - Phone:773-439-9908
Mailing Address - Fax:312-264-0372
Practice Address - Street 1:12520 S STEWART AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-7231
Practice Address - Country:US
Practice Address - Phone:773-439-9908
Practice Address - Fax:312-264-0372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL69251749251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health