Organization
AVANCER HOMES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESIREE A JOHNSON (EXECUTIVE DIRECTOR)
(815) 784-5146
Entity
Organization
Contact information
Practice address
350 SYCAMORE RD, GENOA, IL 60135-1361
(815) 784-5146
(815) 784-4673
Mailing address
350 SYCAMORE RD, GENOA, IL 60135-1361
(815) 784-5146
(815) 784-4673
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/09/2015
Last updated
02/09/2015
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