Provider Demographics
NPI:1497109284
Name:ABOVE & BEYOND FAMILY RECOVERY CENTER
Entity Type:Organization
Organization Name:ABOVE & BEYOND FAMILY RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSTETLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-940-2960
Mailing Address - Street 1:2942 W LAKE ST.
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:773-940-2960
Mailing Address - Fax:773-940-2996
Practice Address - Street 1:2942 W LAKE ST.
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:773-940-2960
Practice Address - Fax:773-940-2996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-18
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty