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Organization
MARYVILLE ACADEMY
Active
Organization
MARYVILLE ACADEMY
Active
Other names
Family Behavioral Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SR. CATHERINE M RYAN (EXECUTIVE DIRECTOR)
(847) 294-1893
Entity
Organization
Contact information
Practice address
701 LEE ST STE 100, DES PLAINES, IL 60016-4543
(847) 390-3004
(847) 390-3016
Mailing address
701 LEE ST STE 100, DES PLAINES, IL 60016-4543
(847) 390-3004
(847) 390-3016
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
IL
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
09/09/2016
Last updated
07/08/2022
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