Provider Demographics
NPI:1811207251
Name:ADULT COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:ADULT COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MILAGROS
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CADC
Authorized Official - Phone:847-593-6201
Mailing Address - Street 1:415 E GOLF RD STE 104
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4049
Mailing Address - Country:US
Mailing Address - Phone:847-593-6201
Mailing Address - Fax:847-593-6215
Practice Address - Street 1:415 E GOLF RD STE 104
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4049
Practice Address - Country:US
Practice Address - Phone:847-593-6201
Practice Address - Fax:847-593-6215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA3925-0001-A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health