Provider Demographics
NPI:1932657418
Name:TRD HOLDINGS, INC.
Entity Type:Organization
Organization Name:TRD HOLDINGS, INC.
Other - Org Name:F.I.T. FITNESS INTEGRATIVE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:H
Authorized Official - Last Name:VACIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-972-0910
Mailing Address - Street 1:458 W EUGENIE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-5654
Mailing Address - Country:US
Mailing Address - Phone:312-488-9683
Mailing Address - Fax:
Practice Address - Street 1:458 W EUGENIE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-5654
Practice Address - Country:US
Practice Address - Phone:312-488-9683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty