Organization
WAY BACK INN
Active
Organization
WAY BACK INN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANITA MARIA PINDIUR MS, LCPC (EXECUTIVE DIRECTOR)
(708) 344-3301
Entity
Organization
Contact information
Practice address
104 OAK ST., MAYWOOD, IL 60153
(708) 344-3301
(708) 344-2944
Mailing address
104 OAK ST., MAYWOOD, IL 60153
(708) 344-3301
(708) 344-2944
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
A-0388-0002-A
IL
251S00000X
Community/Behavioral Health Agency
A-0388-0004-A
IL
251S00000X
Community/Behavioral Health Agency
A-0388-0008-A
IL
251S00000X
Community/Behavioral Health Agency
A-0388-0009-A
IL
251S00000X
Community/Behavioral Health Agency
A-0388-0010-A
IL
251S00000X
Community/Behavioral Health Agency
A-0388-0011-A
IL
324500000X
Substance Abuse Rehabilitation Facility
A-0388-0001-A
IL
324500000X
Substance Abuse Rehabilitation Facility
A-0388-0002-A
IL
324500000X
Substance Abuse Rehabilitation Facility
A-0388-0004-A
IL
324500000X
Substance Abuse Rehabilitation Facility
A-0388-0007-A
IL
324500000X
Substance Abuse Rehabilitation Facility
A-0388-0008-A
IL
324500000X
Substance Abuse Rehabilitation Facility
Primary
A-0388-0009-A
IL
324500000X
Substance Abuse Rehabilitation Facility
A-0388-0010-A
IL
324500000X
Substance Abuse Rehabilitation Facility
A-0388-0011-A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A-0388-0002-A
DHS-DASA
IL
05
—
C-A-0388-0002-A
—
IL
Enumeration date
05/17/2011
Last updated
08/23/2022
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