Organization
RRAF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARILYN J FLANAGAN QIDP (EXECUTIVE DIRECTOR & SR. VP)
(630) 495-7723
Entity
Organization
Contact information
Practice address
613 SOUTH MAIN STREET, LOMBARD, IL 60148
(630) 495-7723
(630) 495-7723
Mailing address
613 SOUTH MAIN STREET, LOMBARD, IL 60148
(630) 495-7723
(630) 495-7723
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
IL
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
IL
261QA0600X
Adult Day Care Clinic/Center
—
—
Other
Enumeration date
06/04/2006
Last updated
12/28/2015
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