Provider Demographics
NPI:1609365519
Name:REFRESH IN-HOME COUNSELING LLC
Entity Type:Organization
Organization Name:REFRESH IN-HOME COUNSELING LLC
Other - Org Name:IN HOME COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERISH
Authorized Official - Middle Name:
Authorized Official - Last Name:REINWALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-903-5604
Mailing Address - Street 1:800 MAIN ST STE 210
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:IL
Mailing Address - Zip Code:60002-1578
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 MAIN ST STE 210
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:IL
Practice Address - Zip Code:60002-1578
Practice Address - Country:US
Practice Address - Phone:847-903-5604
Practice Address - Fax:224-788-5112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-07
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001609365519Medicaid