Provider Demographics
NPI:1700364114
Name:CHILD AND FAMILY TREATMENT, LLC
Entity Type:Organization
Organization Name:CHILD AND FAMILY TREATMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARYEH
Authorized Official - Middle Name:
Authorized Official - Last Name:SOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-482-5696
Mailing Address - Street 1:2835 N SHEFFIELD AVE STE 221
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5083
Mailing Address - Country:US
Mailing Address - Phone:917-482-5696
Mailing Address - Fax:
Practice Address - Street 1:2835 N SHEFFIELD AVE STE 221
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5083
Practice Address - Country:US
Practice Address - Phone:917-482-5696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008681103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty