Provider Demographics
NPI:1063174076
Name:MAYS & ASSOCIATES FULL COURT PROGRAM LLC
Entity type:Organization
Organization Name:MAYS & ASSOCIATES FULL COURT PROGRAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERIPIST
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGS
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:708-465-8747
Mailing Address - Street 1:3719 216TH PL APT 1
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-3735
Mailing Address - Country:US
Mailing Address - Phone:708-465-8747
Mailing Address - Fax:
Practice Address - Street 1:3719 216TH PL APT 1
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-3735
Practice Address - Country:US
Practice Address - Phone:708-465-8747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health