Organization
RIVERSIDE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH ROGERS (EXECUTIVE DIRECTOR)
(847) 634-3973
Entity
Organization
Contact information
Practice address
14588 W HIGHWAY 22, LINCOLNSHIRE, IL 60069-3024
(847) 634-3973
(847) 634-0227
Mailing address
14588 W HIGHWAY 22, LINCOLNSHIRE, IL 60069-3024
(847) 634-3973
(847) 634-0227
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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