Organization
0013 ELISABETH LUDEMAN CENTER
Active
Other names
Home 13
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID I DECKER (CENTER DIRECTOR)
(708) 283-3001
Entity
Organization
Contact information
Practice address
114 N ORCHARD DR, PARK FOREST, IL 60466-1200
(708) 283-3000
(708) 283-3020
Mailing address
114 N ORCHARD DR, PARK FOREST, IL 60466-1200
(708) 283-3000
(708) 283-3020
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
000953261001
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000953261001
—
IL
Enumeration date
03/07/2007
Last updated
06/13/2008
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