Organization
WM. W. FOX DEVELOPMENTAL CENTER 3C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUS PEDRAZA (MEDICAL DIRECTOR)
(815) 584-3347
Entity
Organization
Contact information
Practice address
134 W MAIN ST, DWIGHT, IL 60420-1322
(815) 584-3347
Mailing address
134 W MAIN ST, DWIGHT, IL 60420-1322
(815) 584-3347
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/16/2007
Last updated
08/22/2020
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