| Powerhouse Aba, Llc | |
|
213 Tamarack Hollow St Sw Poplar Grove IL 61065-8931 | |
| (630) 283-2962 | |
| Not Available |
| Full Name | Powerhouse Aba, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 213 Tamarack Hollow St Sw, Poplar Grove, Illinois |
| Authorized Official Name and Position | Alyssa Figueroa (BEHAVIOR ANALYST) |
| Authorized Official Contact | 6302832962 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Powerhouse Aba, Llc 444 E Roosevelt Rd Ste 310 Lombard IL 60148-4630 Ph: (630) 283-2962 | Powerhouse Aba, Llc 213 Tamarack Hollow St Sw Poplar Grove IL 61065-8931 Ph: (630) 283-2962 |
| NPI Number | 1942837380 |
|---|---|
| Provider Enumeration Date | 03/25/2020 |
| Last Update Date | 03/16/2022 |
| Certification Date | 03/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942837380 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
Revive Therapy And Wellness Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 117 Minarette Dr Sw, Poplar Grove, IL 61065 Phone: 815-575-9887 |