| Obsidian Holistic Services, Llc | |
|
930 175th St Ste 1e Homewood IL 60430-2078 | |
| (708) 462-2134 | |
| Not Available |
| Full Name | Obsidian Holistic Services, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 930 175th St Ste 1e, Homewood, Illinois |
| Authorized Official Name and Position | Erica Washington (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 7084622134 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Obsidian Holistic Services, Llc 930 175th St Ste 1e Homewood IL 60430-2078 Ph: (708) 462-2134 | Obsidian Holistic Services, Llc 930 175th St Ste 1e Homewood IL 60430-2078 Ph: (708) 462-2134 |
| NPI Number | 1801409008 |
|---|---|
| Provider Enumeration Date | 08/26/2020 |
| Last Update Date | 03/23/2023 |
| Certification Date | 03/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801409008 | NPI | - | NPPES |
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