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General NPI Number Information
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NPI Number | 1962941831
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Entity Type | Organization
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Legal Business Name | IN HOME COUNSELING FOR SENIORS
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Dates
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Enumeration Date | 02/13/2017
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Last Update Date | 02/13/2017
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Provider Practice Location Address
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Address Line | 908 N WOLCOTT AVE 2
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City | CHICAGO
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State | IL
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Zip | 60622
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Country | US
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Telephone | 815-878-2663
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Fax |
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Provider Business Mailing Address
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Address Line | 908 N WOLCOTT AVE 2
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City | CHICAGO
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State | IL
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Zip | 60622
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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 | COUNSELOR
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Name | RACHEL SAFRANSKI
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Credential |
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Telephone | 815-878-2663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 149016120
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License Number State | IL
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