Organization
MENTAL HEALTH AND DEAFNESS RESOURCES
Active
Other names
Prairieview Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GAIL FISHER (ADMINISTRATOR)
(847) 509-8260
Entity
Organization
Contact information
Practice address
19407 US HIGHWAY 150, BLOOMINGTON, IL 61705-5858
(309) 378-1509
Mailing address
614 ANTHONY TRL, NORTHBROOK, IL 60062-2540
(847) 509-8260
(847) 509-8157
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
398621
IL
Other
Enumeration date
06/23/2011
Last updated
06/23/2011
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