NPI | 1548200934 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN R KROOS Executive Director 815-895-5108 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IL 91C046) |
Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
Enumeration Date | 2006-06-07 |
Last Update Date | 2020-08-22 |