Organization
CLEARBROOK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL M LA MELL (PRESIDENT)
(847) 870-7711
Entity
Organization
Contact information
Practice address
1835 W CENTRAL ROAD, ARLINGTON HEIGHTS, IL 60005-2410
(847) 870-7711
(847) 870-7741
Mailing address
1835 W CENTRAL ROAD, ARLINGTON HEIGHTS, IL 60005-2410
(847) 870-7711
(847) 870-7741
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033023
—
IL
05
—
033027
—
IL
05
—
033035
—
IL
05
—
037820
—
IL
Enumeration date
07/12/2006
Last updated
08/22/2020
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