| T.h.a.t Life | |
|
2314 Illinois Route 59 #111 Plainfield IL 60586 | |
| (815) 556-9430 | |
| Not Available |
| Full Name | T.h.a.t Life |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2314 Illinois Route 59 #111, Plainfield, Illinois |
| Authorized Official Name and Position | Hiram White (CO-CHAIR) |
| Authorized Official Contact | 8155569430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| T.h.a.t Life 2314 Illinois Route 59 #111 Plainfield IL 60586 Ph: (815) 556-9430 | T.h.a.t Life 2314 Illinois Route 59 #111 Plainfield IL 60586 Ph: (815) 556-9430 |
| NPI Number | 1730892258 |
|---|---|
| Provider Enumeration Date | 12/29/2022 |
| Last Update Date | 12/29/2022 |
| Certification Date | 12/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730892258 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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