Organization
HEALTHY LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CASSANDRA KANDAH PH.D (FOUNDER)
(248) 495-8165
Entity
Organization
Contact information
Practice address
200 W MADISON ST STE 2100, CHICAGO, IL 60606-3521
(248) 495-8165
(773) 353-1581
Mailing address
2729 N MAPLEWOOD AVE, CHICAGO, IL 60647-1930
(248) 495-8165
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/09/2019
Last updated
04/23/2019
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