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General NPI Number Information
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NPI Number | 1689299497
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Entity Type | Organization
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Legal Business Name | MINDSET TRANSFORMATIONS, LLC
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Dates
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Enumeration Date | 06/08/2020
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 11225 FRONT ST STE 16
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City | MOKENA
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State | IL
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Zip | 60448-1303
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Country | US
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Telephone | 708-537-7332
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Fax |
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Provider Business Mailing Address
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Address Line | 11225 FRONT ST STE 16
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City | MOKENA
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State | IL
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Zip | 60448-1303
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Country | US
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Telephone | 708-537-7332
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VALERIE HAMMOND
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Credential | MACP, CRADC, SAP
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Telephone | 708-537-7332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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