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Organization

VANDALIA TERRACE, LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BYRON WITT (ADMINISTRATOR)
(618) 283-1434
Entity
Organization

Contact information

Practice address
3845 OAKTON ST, SKOKIE, IL 60076-3429
(847) 679-0100
(847) 679-0673
Mailing address
3845 OAKTON ST, SKOKIE, IL 60076-3429
(847) 679-0100
(847) 679-0673

Taxonomy

Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
1687983
IL

Other

Enumeration date
05/01/2006
Last updated
08/22/2020
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