Provider Demographics
NPI:1770057978
Name:FAMILY FOCUS INC.
Entity type:Organization
Organization Name:FAMILY FOCUS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-962-0366
Mailing Address - Street 1:310 S PEORIA ST STE 301
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3534
Mailing Address - Country:US
Mailing Address - Phone:818-531-2421
Mailing Address - Fax:
Practice Address - Street 1:6727 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60636-2414
Practice Address - Country:US
Practice Address - Phone:773-962-0366
Practice Address - Fax:773-962-0966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2B17-IPI-003Medicaid