Organization
LILY OF THE VALLEY SUPPORT ACADEMY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIAMOND HINES LPN/ DON (CEO)
(773) 757-3101
Entity
Organization
Contact information
Practice address
14302 S LA SALLE ST, RIVERDALE, IL 60827-2743
(773) 757-3101
Mailing address
14302 S LA SALLE ST, RIVERDALE, IL 60827-2743
(773) 757-3101
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/04/2025
Last updated
11/04/2025
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