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1073801452
OMEGA LASTER
CHICAGO, IL
NPI
1073801452
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IL 17601)
Enumeration Date
2011-07-19
Last Update Date
2011-07-19
Business Address
-- OMEGA LASTER CADC
4740 N CLARK ST
CHICAGO, IL 60640-4689
Phone number: 773-769-0205
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Mailing Address
-- OMEGA LASTER CADC
4740 N CLARK ST
CHICAGO, IL 60640-4689
Phone number: 773-769-0205
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