Organization
ARDEN SHORE CHILD AND FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JEANETTE OLIVER (QUALITY ASSURANCE MANAGER)
(847) 549-1730
Entity
Organization
Contact information
Practice address
2504 WASHINGTON ST, SUITE 200, WAUKEGAN, IL 60085-4983
(847) 662-4464
(847) 662-4530
Mailing address
935 LAKEVIEW PKWY, SUITE 105, VERNON HILLS, IL 60061-1443
(847) 549-1730
(847) 549-1731
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2B05CHR018
—
IL
Enumeration date
02/18/2010
Last updated
02/18/2010
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