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Organization

THE DUBOIS DOUGLAS CENTRES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARCEL MARTINS-MENSAH (PRESIDENT)
(708) 283-0886
Entity
Organization

Contact information

Practice address
4747 LINCOLN MALL DR, SUITE 301, MATTESON, IL 60443-3811
(708) 283-0886
(708) 283-0895
Mailing address
4747 LINCOLN MALL DR, SUITE 301, MATTESON, IL 60443-3811
(708) 283-0886
(708) 283-0895

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
199500004C
IL

Other

Enumeration date
07/15/2015
Last updated
07/15/2015
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