Organization
GARDEN CENTER SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JILL SMITH (CHIEF ACCOUNTANT)
(773) 941-4151
Entity
Organization
Contact information
Practice address
8333 AUSTIN AVE, BURBANK, IL 60459-2558
(708) 636-0054
(708) 636-7955
Mailing address
8333 AUSTIN AVE, BURBANK, IL 60459-2558
(708) 636-0054
(708) 636-7955
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
36103
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001
—
IL
01
—
14G251
MEDICARE
—
Enumeration date
04/19/2007
Last updated
05/12/2016
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