Provider Demographics
NPI:1013750009
Name:BETTER SISTER AND BROTHER GROWTH NETWORK
Entity type:Organization
Organization Name:BETTER SISTER AND BROTHER GROWTH NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LUKESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-566-1185
Mailing Address - Street 1:29 W 159TH ST
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:IL
Mailing Address - Zip Code:60426-4906
Mailing Address - Country:US
Mailing Address - Phone:708-566-1185
Mailing Address - Fax:708-566-1190
Practice Address - Street 1:29 W 159TH ST
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:IL
Practice Address - Zip Code:60426-4906
Practice Address - Country:US
Practice Address - Phone:708-566-1185
Practice Address - Fax:708-566-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-17
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No174200000XOther Service ProvidersMeals
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty