Provider Demographics
NPI:1619622685
Name:VERDURE HEALTH LLC
Entity Type:Organization
Organization Name:VERDURE HEALTH LLC
Other - Org Name:VERDURE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENISHA
Authorized Official - Middle Name:LC
Authorized Official - Last Name:FOREMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:224-637-6999
Mailing Address - Street 1:1761 N DILLEYS RD STE 210
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-1721
Mailing Address - Country:US
Mailing Address - Phone:224-419-5053
Mailing Address - Fax:
Practice Address - Street 1:1761 N DILLEYS RD STE 210
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-1721
Practice Address - Country:US
Practice Address - Phone:224-419-5053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-17
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty