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General NPI Number Information
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NPI Number | 1932400199
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Entity Type | Organization
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Legal Business Name | ADULT COUNSELING CENTER, INC.
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 415 E GOLF ROAD STE 104
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-4049
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Country | US
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Telephone | 847-593-6201
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Fax |
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Provider Business Mailing Address
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Address Line | 415 E GOLF RD STE 104
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-4049
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Country | US
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Telephone | 847-593-6201
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. MILLIE HERNANDEZ
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Credential | MA, CADC
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Telephone | 847-593-6201
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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 | A-3825-0001-A
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License Number State | IL
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