Organization
ARDEN SHORE CHILD AND FAMILY SERVICES
Active
Other names
Waukegan Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DORA MAYA PHD (PRESIDENT/CEO)
(847) 623-1730
Entity
Organization
Contact information
Practice address
3100 CORNELL RD, WAUKEGAN, IL 60087-2247
(847) 263-1858
(847) 263-4190
Mailing address
3100 CORNELL RD, WAUKEGAN, IL 60087-2247
(847) 263-1858
(847) 263-4190
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
31414206
IL
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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