Provider Demographics
NPI:1740940741
Name:BRAIN BOX LITERACY ACADEMY AND EDUCATIONAL SERVICES
Entity type:Organization
Organization Name:BRAIN BOX LITERACY ACADEMY AND EDUCATIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AYESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-230-9682
Mailing Address - Street 1:1510 KINROSS ST
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-4314
Mailing Address - Country:US
Mailing Address - Phone:773-230-9682
Mailing Address - Fax:773-424-3000
Practice Address - Street 1:9304 S ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-5119
Practice Address - Country:US
Practice Address - Phone:773-230-9682
Practice Address - Fax:773-424-3000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-19
Last Update Date:2021-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care