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Organization
LIFEPLACE, INC.
Active
Organization
LIFEPLACE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DREW MICHAEL MJOEN M.A., LCPC (PRESIDENT)
(847) 557-0645
Entity
Organization
Contact information
Practice address
1580 S MILWAUKEE AVE, SUITE 307, LIBERTYVILLE, IL 60048-3764
(847) 557-0645
(847) 557-9809
Mailing address
1580 S MILWAUKEE AVE, SUITE 307, LIBERTYVILLE, IL 60048-3764
(847) 557-0645
(847) 557-9809
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180003417
IL
Other
Enumeration date
04/03/2012
Last updated
04/03/2012
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