Provider Demographics
NPI:1215252820
Name:HUMAN CORPS, INC.
Entity type:Organization
Organization Name:HUMAN CORPS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMBLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:708-547-8150
Mailing Address - Street 1:P.O. BOX 6801
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60155
Mailing Address - Country:US
Mailing Address - Phone:708-547-8150
Mailing Address - Fax:
Practice Address - Street 1:2316 WASHINGTON BLVD
Practice Address - Street 2:STE. A2E
Practice Address - City:BELLWOOD
Practice Address - State:IL
Practice Address - Zip Code:60104-1656
Practice Address - Country:US
Practice Address - Phone:708-547-8150
Practice Address - Fax:708-547-8151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty