Organization
A BEAUTIFUL MIND LICENSE RESTORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHIQUITA LEE (CEO)
(312) 340-8826
Entity
Organization
Contact information
Practice address
5113 S HARPER AVE STE 2C, CHICAGO, IL 60615-4119
(773) 304-3699
Mailing address
5113 S HARPER AVE STE 2C, CHICAGO, IL 60615-4119
(773) 304-3699
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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