Organization
KELLY ACCURATE DUI TREATMENT SERVICES, LLC
Active
Other names
kelly accurate dui
Organization subpart
No
Provider details
NPI number
Authorized official
MISS RENEE PATRICE KELLY CADC (OWNER /DIRECTOR)
(708) 323-8270
Entity
Organization
Contact information
Practice address
20550 S LAGRANGE RD, LOWER LEVEL, FRANKFORT, IL 60423-1397
(815) 630-8828
Mailing address
20550 S LAGRANGE RD, LOWER LEVEL, FRANKFORT, IL 60423-1397
(815) 630-8828
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341642079001
—
IL
01
—
A5452002A
CADC CERTIFICATION LICENSE NUMBER
IL
Enumeration date
05/09/2016
Last updated
06/10/2019
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