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General NPI Number Information
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NPI Number | 1649305731
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Entity Type | Organization
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Legal Business Name | PARTNERS IN RECOVERY LTD
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18208 DOLPHIN LAKE DRIVE
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City | HOMEWOOD
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State | IL
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Zip | 60430-1507
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Country | US
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Telephone | 708-957-3303
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Fax | 708-957-3764
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Provider Business Mailing Address
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Address Line | 18208 DOLPHIN LAKE DR
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City | HOMEWOOD
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State | IL
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Zip | 60430-1507
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Country | US
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Telephone | 708-957-3303
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Fax | 708-957-3764
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JAN L SMITH
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Credential | MA
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Telephone | 708-957-3303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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