Organization
ARDEN SHORE CHILD AND FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DORA MAYA PHD (CEO/ PRESIDENT)
(847) 623-1730
Entity
Organization
Contact information
Practice address
329 N GENESEE ST, WAUKEGAN, IL 60085-4205
(847) 623-1730
(847) 623-1733
Mailing address
329 N GENESEE ST, WAUKEGAN, IL 60085-4205
(847) 623-1730
(847) 623-1733
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253J00000X
Foster Care Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
31414206
IL
Other
Enumeration date
11/15/2011
Last updated
11/15/2011
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