Organization
CENTERS FOR RESIDENTIAL ALTERNATIVES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE HUMPHREY III (EXECUTIVE DIRECTOR)
(708) 339-3100
Entity
Organization
Contact information
Practice address
625 E 170TH ST, SUITE 2 - E, SOUTH HOLLAND, IL 60473-3479
(708) 339-3100
(708) 339-3200
Mailing address
625 E 170TH ST, SUITE 2 - E, SOUTH HOLLAND, IL 60473-3479
(708) 339-3100
(708) 339-3200
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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