Root & Vines Wellness, Pllc

NPI #1013774587 in Chicago, Illinois

Provider Information

NPI Number: 1013774587
Entity Type: Organization
Organization Name: Root & Vines Wellness, Pllc
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Mar 1, 2024
Last Updated: Mar 1, 2024

Practice Location

Address: 2919 N RACINE AVE BSMT
City: Chicago
State: Illinois
ZIP Code: 60657-4223
Phone: (505) 331-3467

Authorized Official

Name: IVY F MALISOW, LCPC
Title: THERAPIST
Phone: (505) 331-3467

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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