| Evening Star Behavioral Service Llc | |
|
2405 Essington Rd Ste B539 Joliet IL 60435-1200 | |
| (301) 523-6323 | |
| Not Available |
| Full Name | Evening Star Behavioral Service Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2405 Essington Rd Ste B539, Joliet, Illinois |
| Authorized Official Name and Position | Keshyra Myers (REGISTERED AGENT) |
| Authorized Official Contact | 3015236323 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evening Star Behavioral Service Llc 2405 Essington Rd Ste B539 Joliet IL 60435-1200 Ph: () - | Evening Star Behavioral Service Llc 2405 Essington Rd Ste B539 Joliet IL 60435-1200 Ph: (301) 523-6323 |
| NPI Number | 1821866559 |
|---|---|
| Provider Enumeration Date | 12/12/2023 |
| Last Update Date | 12/12/2023 |
| Certification Date | 12/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821866559 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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