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General NPI Number Information
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NPI Number | 1598533291
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Entity Type | Organization
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Legal Business Name | THE LIVING ROOM EXPERIENCE BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 12/13/2023
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 1 WESTBROOK CORPORATE CTR STE 300
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City | WESTCHESTER
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State | IL
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Zip | 60154-5709
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Country | US
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Telephone | 708-722-5080
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Fax |
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Provider Business Mailing Address
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Address Line | 1 WESTBROOK CORPORATE CTR STE 300
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City | WESTCHESTER
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State | IL
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Zip | 60154-5709
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Country | US
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Telephone | 708-722-5080
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. SADE V HARRINGTON
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Credential |
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Telephone | 708-722-5080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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