Organization
MARYVILLE ACADEMY
Active
Other names
St. George
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY Z WOULFE (DIRECTOR OF BUSINESS DEVELOPMENT)
(847) 294-1910
Entity
Organization
Contact information
Practice address
1150 N RIVER RD, DES PLAINES, IL 60016-1214
(847) 294-1999
(847) 294-2892
Mailing address
1150 N RIVER RD, DES PLAINES, IL 60016-1214
(847) 294-1999
(847) 294-2892
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
IL
Other
Enumeration date
10/05/2010
Last updated
07/08/2022
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