Organization
ASSOCIATION FOR INDIVIDUAL DEVELOPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED OLDMEN JALLOH BA (MENTAL HEALTH PROFESSIONAL)
(331) 425-5280
Entity
Organization
Contact information
Practice address
1230 N HIGHLAND AVE, AURORA, IL 60506-1401
(630) 966-4000
Mailing address
1230 N HIGHLAND AVE, AURORA, IL 60506-1401
(630) 966-4000
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/13/2016
Last updated
10/13/2016
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