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General NPI Number Information
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NPI Number | 1669253936
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Entity Type | Organization
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Legal Business Name | LIFEBUILDERS NFP
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Dates
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Enumeration Date | 10/11/2023
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 1634 VOLLBRECHT DR
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City | SOUTH HOLLAND
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State | IL
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Zip | 60473-3641
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Country | US
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Telephone | 773-213-9702
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Fax |
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Provider Business Mailing Address
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Address Line | 10204 S FOREST AVE
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City | CHICAGO
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State | IL
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Zip | 60628-2108
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Country | US
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Telephone | 773-213-9702
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ERIC MICHAEL ARNOLD
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Credential | BA, CADC
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Telephone | 773-213-9702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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