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General NPI Number Information
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NPI Number | 1376782474
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Entity Type | Organization
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Legal Business Name | FOREST COUNSELING SERVICE INC
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Dates
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Enumeration Date | 02/12/2009
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Last Update Date | 02/12/2009
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Provider Practice Location Address
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Address Line | 9050 W 81ST ST
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City | JUSTICE
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State | IL
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Zip | 60458-1350
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Country | US
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Telephone | 708-325-1052
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Fax | 708-325-1053
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Provider Business Mailing Address
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Address Line | 9050 W 81ST ST
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City | JUSTICE
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State | IL
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Zip | 60458-1350
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Country | US
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Telephone | 708-325-1052
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Fax | 708-325-1053
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Authorized Official
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Title or Position | TECHNICIAN/INSURANCE COORDINATOR
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Name | MRS. LINDA BAILEY
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Credential |
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Telephone | 708-594-3000
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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 | A44560001A
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License Number State | IL
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