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General NPI Number Information
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NPI Number | 1467226365
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Entity Type | Organization
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Legal Business Name | BQUALLS BEHAVIORAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 11/10/2023
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 18515 COUNTRY LN
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City | LANSING
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State | IL
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Zip | 60438-2582
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Country | US
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Telephone | 708-925-5135
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 645
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City | LANSING
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State | IL
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Zip | 60438-0645
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Country | US
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Telephone | 708-513-4480
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRANDI QUALLS
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Credential |
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Telephone | 708-513-4480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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