Organization
RL GROUP
Active
Other names
Reinvent Life Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYNN FIELDS TYLER (MANAGER)
(708) 860-1201
Entity
Organization
Contact information
Practice address
2008 N LAWLER AVE, CHICAGO, IL 60639-3136
(708) 860-1201
(708) 221-6679
Mailing address
511 MANISTEE AVE, CALUMET CITY, IL 60409-3311
(708) 860-1201
(708) 221-6679
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20191009481556
—
IL
01
—
A-2560-0001-A
STATE OF ILLINOIS LEVEL 1 AND 2 LICENSE
IL
01
—
F100604483
MEDICARE
IL
Enumeration date
06/09/2019
Last updated
11/19/2020
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