Organization
T.H.A.T LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HIRAM WHITE (CO-CHAIR)
(815) 556-9430
Entity
Organization
Contact information
Practice address
2314 ILLINOIS ROUTE 59 #111, PLAINFIELD, IL 60586
(815) 556-9430
Mailing address
2314 ILLINOIS ROUTE 59 #111, PLAINFIELD, IL 60586
(815) 556-9430
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/29/2022
Last updated
12/29/2022
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