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General NPI Number Information
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NPI Number | 1487586749
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Entity Type | Organization
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Legal Business Name | MINDFUL LIVING CENTER ILLINOIS JOLIET LLC
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Dates
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Enumeration Date | 06/01/2026
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | 54 N OTTAWA ST STE 245
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City | JOLIET
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State | IL
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Zip | 60432-4378
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Country | US
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Telephone | 815-277-5050
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Fax |
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Provider Business Mailing Address
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Address Line | 900 PACIFIC COAST HWY APT 105
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-4859
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Country | US
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Telephone | 213-510-7904
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Fax |
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Authorized Official
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Title or Position | VP
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Name | ERIK TOLONEN
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Credential |
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Telephone | 213-510-7904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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