Organization
MARYVILLE ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY Z WOULFE (DIRECTOR OF BUSINESS DEVELOPMENT)
(847) 294-1910
Entity
Organization
Contact information
Practice address
ST. MARY OF CELLE, 1431 EUCLID AVENUE, BERWYN, IL 60402
(630) 736-7480
Mailing address
1150 N RIVER RD, DES PLAINES, IL 60016-1214
(847) 294-1910
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
10/13/2021
Last updated
07/19/2022
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