Provider Demographics
NPI:1336915826
Name:GARDEN CENTER SERVICES
Entity Type:Organization
Organization Name:GARDEN CENTER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DIRECTOR/SPECIAL PROJECTS
Authorized Official - Prefix:
Authorized Official - First Name:DESHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-967-3074
Mailing Address - Street 1:10444 S KEDZIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60655-2018
Mailing Address - Country:US
Mailing Address - Phone:708-967-3074
Mailing Address - Fax:773-941-4591
Practice Address - Street 1:8333 AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:IL
Practice Address - Zip Code:60459-2558
Practice Address - Country:US
Practice Address - Phone:708-636-0054
Practice Address - Fax:708-636-7955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health