Organization
EVOLVE THERAPEUTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA DECRAENE (OWNER)
(815) 685-7601
Entity
Organization
Contact information
Practice address
304 W MONDAMIN ST, SUITE 104, MINOOKA, IL 60447-9096
(815) 685-7601
Mailing address
PO BOX 608, MINOOKA, IL 60447-0608
(815) 685-7601
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.008724
IL
Other
Enumeration date
09/27/2016
Last updated
09/27/2016
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