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General NPI Number Information
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NPI Number | 1194270371
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Entity Type | Organization
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Legal Business Name | RIMYA, LLC
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Dates
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Enumeration Date | 08/17/2016
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Last Update Date | 08/17/2016
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Provider Practice Location Address
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Address Line | 2545 W DIVERSEY AVE SUITE #230
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City | CHICAGO
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State | IL
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Zip | 60647-7172
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Country | US
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Telephone | 708-465-1293
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Fax |
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Provider Business Mailing Address
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Address Line | 2545 W DIVERSEY AVE SUITE #230
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City | CHICAGO
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State | IL
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Zip | 60647-7172
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | CHRISTINA LU
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Credential | AMFT
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Telephone | 773-956-0334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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