OrganizationActive
Community Support Services
NPI 1316036486 · Social Worker · Brookfield, IL
Provider details
- NPI number
- 1316036486
- Entity type
- Organization
- Primary specialty
- Social WorkerBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Diane Farina White, President and Ceo(708) 354-4547
- License
- 150010241 (IL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
- Case Management Agency251B00000X
Agencies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility320900000XLicense 199400214C (IL)
Residential Treatment Facilities
Practice location
9021 Ogden Avenue
Brookfield, IL 60513
Phone: (708) 354-4547
Fax: (708) 354-7412
Approximate (ZIP-level) locationGet directions
Mailing address
9021 Ogden Ave
Brookfield, IL 60513
Registry dates
- Enumerated
- 2006-10-12
- Last updated
- 2015-11-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.