Provider Demographics
NPI:1801541156
Name:PRESENT MOMENT JOURNEYS LLC
Entity type:Organization
Organization Name:PRESENT MOMENT JOURNEYS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEMBA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BAYO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:872-600-2029
Mailing Address - Street 1:1096 W PRATT BLVD APT 1S
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-4480
Mailing Address - Country:US
Mailing Address - Phone:872-600-2029
Mailing Address - Fax:855-783-8724
Practice Address - Street 1:1150 W LUNT AVE STE B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-3520
Practice Address - Country:US
Practice Address - Phone:872-600-2029
Practice Address - Fax:855-783-8724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health