| Living Color Wellness Llc | |
|
14958 W Cyrus Dr Manhattan IL 60442-7749 | |
| (312) 972-8605 | |
| Not Available |
| Full Name | Living Color Wellness Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 14958 W Cyrus Dr, Manhattan, Illinois |
| Authorized Official Name and Position | Christine I Miller (OWNER/ CEO) |
| Authorized Official Contact | 3129728605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Color Wellness Llc Po Box 645 Manhattan IL 60442-0645 Ph: (312) 972-8605 | Living Color Wellness Llc 14958 W Cyrus Dr Manhattan IL 60442-7749 Ph: (312) 972-8605 |
| NPI Number | 1003678186 |
|---|---|
| Provider Enumeration Date | 01/25/2024 |
| Last Update Date | 01/25/2024 |
| Certification Date | 01/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003678186 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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