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Organization
CHICAGO WELLNESS AND SUPPORT LLC
Active
Organization
CHICAGO WELLNESS AND SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE WALKER (OWNER)
(480) 619-0949
Entity
Organization
Contact information
Practice address
2833 E 79TH ST, CHICAGO, IL 60649-5213
(773) 873-7335
Mailing address
16211 N SCOTTSDALE RD STE A6A267, SCOTTSDALE, AZ 85254-1584
(480) 619-0949
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/17/2024
Last updated
09/24/2024
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