| NPI | 1528319969 |
|---|---|
| Other Name | WAUKEGAN GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | DORA MAYA President/CEO 847-623-1730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: IL 31414206) |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2012-09-25 |