Organization
AVANCER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DESIREE ALICIA HENDERSON-SAWYER (EXECUTIVE DIRECTOR)
(815) 784-3712
Entity
Organization
Contact information
Practice address
350 SYCAMORE RD, GENOA, IL 60135-1361
(815) 784-5146
(815) 784-4673
Mailing address
350 SYCAMORE RD, GENOA, IL 60135-1361
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
01C008
IL
Other
Enumeration date
03/02/2007
Last updated
08/22/2020
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