| Hackmatack, Llc. | |
|
3213 E East Solon Rd Richmond IL 60071-9675 | |
| (815) 528-4522 | |
| Not Available |
| Full Name | Hackmatack, Llc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 3213 E East Solon Rd, Richmond, Illinois |
| Authorized Official Name and Position | Grant Goehler (DIRECTOR) |
| Authorized Official Contact | 8155284522 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hackmatack, Llc. 3213 E East Solon Rd Richmond IL 60071-9675 Ph: (815) 528-4522 | Hackmatack, Llc. 3213 E East Solon Rd Richmond IL 60071-9675 Ph: (815) 528-4522 |
| NPI Number | 1033871793 |
|---|---|
| Provider Enumeration Date | 10/11/2021 |
| Last Update Date | 10/11/2021 |
| Certification Date | 10/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033871793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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