Organization
HACKMATACK, LLC.
Active
Other names
Good Works Collective
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GRANT GOEHLER LCSW (DIRECTOR)
(815) 528-4522
Entity
Organization
Contact information
Practice address
3213 E EAST SOLON RD, RICHMOND, IL 60071-9675
(815) 528-4522
Mailing address
3213 E EAST SOLON RD, RICHMOND, IL 60071-9675
(815) 528-4522
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/11/2021
Last updated
10/11/2021
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