| Blossom & Sprout Wellness, Pllc | |
|
4263 Greenleaf Ct Park City IL 60085-8540 | |
| (224) 788-0188 | |
| Not Available |
| Full Name | Blossom & Sprout Wellness, Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4263 Greenleaf Ct, Park City, Illinois |
| Authorized Official Name and Position | Lafay Erving (EXECUTIVE CLINICAL DIRECTOR) |
| Authorized Official Contact | 2242378037 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossom & Sprout Wellness, Pllc 1146 S Waukegan Rd Ste 378 Waukegan IL 60085-6731 Ph: (224) 788-0188 | Blossom & Sprout Wellness, Pllc 4263 Greenleaf Ct Park City IL 60085-8540 Ph: (224) 788-0188 |
| NPI Number | 1932950953 |
|---|---|
| Provider Enumeration Date | 03/28/2024 |
| Last Update Date | 03/28/2024 |
| Certification Date | 03/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932950953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Lake County Health Department And Community Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4118 Greenleaf Ct Apt 202, Park City, IL 60085 Phone: 847-377-8000 | |
Lake County Health Department And Community Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4118 Greenleaf Ct, Park City, IL 60085 Phone: 847-377-8170 |