Organization
COVENANT ENABLING RESIDENCES OF ILLINOIS
Active
Other names
Bjorklund House
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE ANN SMITH (ADMINISTRATOR)
(708) 687-2038
Entity
Organization
Contact information
Practice address
15841 TERRACE DR, OAK FOREST, IL 60452-2911
(708) 687-2038
(708) 687-2762
Mailing address
15841 TERRACE DR, OAK FOREST, IL 60452-2911
(708) 687-2038
(708) 687-2762
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
08/06/2016
Last updated
08/06/2016
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