Organization
CENTER FOR AUTHENTIC LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARI RICHKO ND LCPC (OWNER)
(847) 668-4869
Entity
Organization
Contact information
Practice address
120 MAIN ST, SUITE 200, PARK RIDGE, IL 60068-4044
(847) 668-4859
Mailing address
120 MAIN ST, SUITE 200, PARK RIDGE, IL 60068-4044
(847) 668-4859
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1326241860
IL
Other
Enumeration date
03/14/2016
Last updated
03/14/2016
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