Organization
COMMUNITY REGIONAL SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOLANLE ADEOYE (EXECUTIVE DIRECTOR)
(773) 615-7648
Entity
Organization
Contact information
Practice address
18765 FOREST VIEW LN, LANSING, IL 60438-4513
(708) 673-7564
Mailing address
18765 FOREST VIEW LN, LANSING, IL 60438-4513
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144
—
IL
Enumeration date
07/14/2021
Last updated
07/14/2021
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