# MARYVILLE ACADEMY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MARYVILLE ACADEMY
- **Other names:** Casa Salama, Maryville Casa Salama
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1760283451
- **Legal business name:** MARYVILLE ACADEMY
- **Authorized official:** MR. FREDERICK SMITH (ADMINISTRATOR OF COMMUNITY SERVICES)
- **Authorized official phone:** (847) 390-3004

## Contact information

- **Practice address:** 951 W BARTLETT RD, BARTLETT, IL 60103-4479
- **Practice address phone:** (630) 736-7450
- **Mailing address:** 1150 N RIVER RD, DES PLAINES, IL 60016-1214
- **Mailing address phone:** (847) 294-1910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | Yes |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 03/20/2025
- **Last updated:** 03/20/2025