Organization Name: | LIFE SYNERGY, LLC |
NPI Number: | 1114332004 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KAREN L VACHULCIK (LICENSED CLINICAL PROF COUNSELOR) |
Mailing Address: | 13235 W Hiawatha Dr Homer Glen |
State: | IL US |
Postal Code: | 604918637 |
Phone Number: | 7089272449 |
Fax Number: | |
NPI Enumeration Date: | 06/30/2014 |
NPI Last Update Date: | 06/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 30730 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |