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General NPI Number Information
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NPI Number | 1336630029
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Entity Type | Organization
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Legal Business Name | REASSEMBLE EDUCATION & TRAINING,INC
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Dates
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Enumeration Date | 05/29/2018
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Last Update Date | 05/29/2018
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Provider Practice Location Address
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Address Line | 644 E 79TH ST STE 15
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City | CHICAGO
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State | IL
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Zip | 60619-3037
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Country | US
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Telephone | 312-296-1069
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Fax | 773-633-8910
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Provider Business Mailing Address
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Address Line | 644 E 79TH ST STE 15
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City | CHICAGO
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State | IL
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Zip | 60619-3037
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Country | US
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Telephone | 312-296-1069
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Fax | 773-633-8910
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Authorized Official
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Title or Position | CEO
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Name | MRS. CARMEN A MEEKINS
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Credential |
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Telephone | 312-296-1069
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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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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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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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