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Organization

MARYVILLE ACADEMY

Active
Other names
Family Behavioral Health Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
SR. CATHERINE M RYAN (EXECUTIVE DIRECTOR)
(847) 294-1893
Entity
Organization

Contact information

Practice address
701 LEE ST STE 100, DES PLAINES, IL 60016-4543
(847) 390-3004
(847) 390-3016
Mailing address
701 LEE ST STE 100, DES PLAINES, IL 60016-4543
(847) 390-3004
(847) 390-3016

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
261QM0850X
Adult Mental Health Clinic/Center
IL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center

Other

Enumeration date
09/09/2016
Last updated
07/08/2022
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