| Transformation Aba | |
|
505 Grove St Chatham IL 62629-1179 | |
| (217) 306-5834 | |
| Not Available |
| Full Name | Transformation Aba |
|---|---|
| Speciality | Behavior Analyst |
| Location | 505 Grove St, Chatham, Illinois |
| Authorized Official Name and Position | Brooke Walker (DIRECTOR) |
| Authorized Official Contact | 2173065834 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transformation Aba 505 Grove St Chatham IL 62629-1179 Ph: (217) 306-5834 | Transformation Aba 505 Grove St Chatham IL 62629-1179 Ph: (217) 306-5834 |
| NPI Number | 1033947510 |
|---|---|
| Provider Enumeration Date | 07/25/2024 |
| Last Update Date | 08/15/2024 |
| Certification Date | 08/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033947510 | NPI | - | NPPES |
| 104633305859002 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
Crossroads Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1835 E Walnut St, Chatham, IL 62629 Phone: 217-483-1224 Fax: 217-483-7135 | |
Dynamic Behavioral Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1605 Sidener Hall, Chatham, IL 62629 Phone: 217-381-8487 |