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General NPI Number Information
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NPI Number | 1841161486
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Entity Type | Organization
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Legal Business Name | INNERGY BEHAVIORAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 875 N MICHIGAN AVE FL 31
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City | CHICAGO
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State | IL
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Zip | 60611-1962
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Country | US
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Telephone | 832-754-6495
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Fax |
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Provider Business Mailing Address
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Address Line | 875 N MICHIGAN AVE FL 31
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City | CHICAGO
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State | IL
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Zip | 60611-1962
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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 | CEO
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Name | TRAVIS LOUALLEN
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Credential |
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Telephone | 832-754-6495
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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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