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Organization

INNER MAN HOLISTIC SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GIA DAVIS (COO)
(708) 397-6200
Entity
Organization

Contact information

Practice address
17601 WENTWORTH AVE, LANSING, IL 60438-2074
(708) 397-6200
Mailing address
1965 BERNICE RD STE 1SW, LANSING, IL 60438-6032

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
03/08/2024
Last updated
03/08/2024
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