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General NPI Number Information
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NPI Number | 1659187029
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Entity Type | Organization
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Legal Business Name | ARENA THERAPY AND JUSTICE CENTER
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 825 N CASS AVE STE 115
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City | WESTMONT
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State | IL
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Zip | 60559-6401
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Country | US
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Telephone | 773-219-0702
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Fax |
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Provider Business Mailing Address
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Address Line | 825 N CASS AVE STE 115
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City | WESTMONT
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State | IL
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Zip | 60559-6401
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND OWNER
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Name | TATIANA DUCHAK
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Credential |
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Telephone | 703-589-3996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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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