Organization
EDEN BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HIDAYAT SHAH LCSW (OWNER)
(708) 967-3092
Entity
Organization
Contact information
Practice address
81 HARMONY LN, ROMEOVILLE, IL 60446-4296
(708) 967-3092
Mailing address
81 HARMONY LN, ROMEOVILLE, IL 60446-4296
(708) 967-3092
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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