# WM. W. FOX DEVELOPMENTAL CENTER 2C

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710021696
- **Authorized official:** DR. GUS PEDRAZA (MEDICAL DIRECTOR)
- **Authorized official phone:** (815) 584-3347

## Contact information

- **Practice address:** 134 W MAIN ST, DWIGHT, IL 60420-1322
- **Practice address phone:** (815) 584-3347
- **Mailing address:** 134 W MAIN ST, DWIGHT, IL 60420-1322
- **Mailing address phone:** (815) 584-3347

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 02/16/2007
- **Last updated:** 08/22/2020