Organization
WAY BACK INN
Active
Parent organization
WAY BACK INN
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAY BACK INN
Authorized official
MS. ANITA MARIA PINDIUR M.S. L.C.P.C (INTERIM EXECUTIVE DIRECTOR)
(708) 344-3301
Entity
Organization
Contact information
Practice address
104 OAK ST., MAYWOOD, IL 60153
(708) 344-3301
(708) 344-2944
Mailing address
104 OAK ST., MAYWOOD, IL 60153
(708) 344-3301
(708) 344-2944
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
180.007242
IL
101YA0400X
Addiction (Substance Use Disorder) Counselor
180.007316
IL
101YP2500X
Professional Counselor
180.007242
IL
101YP2500X
Professional Counselor
180.007316
IL
Other
Enumeration date
07/18/2012
Last updated
08/23/2022
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