Organization
MARYVILLE ACADEMY
Active
Other names
Maryville Madden Shelter
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
1658 W GRAND AVE, CHICAGO, IL 60622-6309
(312) 491-3500
Mailing address
1150 N RIVER RD, DES PLAINES, IL 60016-1214
(847) 294-1999
(847) 294-2892
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/22/2010
Last updated
07/08/2022
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