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General NPI Number Information
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NPI Number | 1235868720
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Entity Type | Organization
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Legal Business Name | REESTABLISHING HOPE INC
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 11/09/2023
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Provider Practice Location Address
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Address Line | 401 E 162ND ST STE 103
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City | SOUTH HOLLAND
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State | IL
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Zip | 60473-2237
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Country | US
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Telephone | 815-418-6577
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Fax |
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Provider Business Mailing Address
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Address Line | 401 E 162ND ST STE 103
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City | SOUTH HOLLAND
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State | IL
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Zip | 60473-2237
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Country | US
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Telephone | 815-418-6577
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARY A CAMPER
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Credential | DD, LSW, MSW, CADC.
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Telephone | 815-418-6577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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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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