Organization
DOLORES & LILLIE'S PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIKKA TAYLOR (MANAGING DIRECTOR)
(651) 278-4230
Entity
Organization
Contact information
Practice address
16252 PRINCE DR, SOUTH HOLLAND, IL 60473-3233
(847) 220-6098
Mailing address
14 W SUPERIOR ST APT 1707, CHICAGO, IL 60654-3706
(651) 278-4230
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
01/25/2025
Last updated
02/24/2025
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