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Organization
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Active
Organization
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Active
Other names
Shapiro Development Center
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA MUHLSTADT (FISCAL ADMINISTRATOR, SODC OPERATIO)
(815) 288-8335
Entity
Organization
Contact information
Practice address
100 E JEFFERY ST, KANKAKEE, IL 60901-5018
(815) 939-8201
(815) 939-8266
Mailing address
100 E JEFFERY ST, KANKAKEE, IL 60901-5018
(815) 939-8201
(815) 939-8266
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
IL
Other
Enumeration date
02/02/2007
Last updated
12/22/2016
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