| Intertwined, Llc | |
|
5233 Stoneridge Ct Matteson IL 60443-2269 | |
| (708) 499-2030 | |
| Not Available |
| Full Name | Intertwined, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5233 Stoneridge Ct, Matteson, Illinois |
| Authorized Official Name and Position | Rochelle Johnson (OWNER) |
| Authorized Official Contact | 7084992030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intertwined, Llc 5233 Stoneridge Ct Matteson IL 60443-2269 Ph: (708) 499-2030 | Intertwined, Llc 5233 Stoneridge Ct Matteson IL 60443-2269 Ph: (708) 499-2030 |
| NPI Number | 1487095907 |
|---|---|
| Provider Enumeration Date | 07/12/2013 |
| Last Update Date | 06/01/2023 |
| Certification Date | 06/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487095907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 149011142 (Illinois) | Primary |
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