Organization
LAKAR ENTERPRISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELVINA STEGALL MHS,CADC, DASA (OWNER)
(708) 263-9512
Entity
Organization
Contact information
Practice address
15525 S PARK AVE STE 114, SOUTH HOLLAND, IL 60473-1380
(708) 263-9512
(708) 825-1244
Mailing address
3343 171ST ST, LANSING, IL 60438-1105
(708) 263-9512
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251S00000X
Community/Behavioral Health Agency
A58520002A
IL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
IL
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
Other
Enumeration date
03/21/2012
Last updated
04/05/2017
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