OrganizationActive
Autism Home Support Services
NPI 1356739478 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Northbrook, IL
Provider details
- NPI number
- 1356739478
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Laura Mckee, Ceo(847) 564-0822
- License
- 0-14-5913 (IL)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 0-14-5913 (IL)
Residential Treatment Facilities
Practice location
85 Revere Dr
Northbrook, IL 60062-8001
Phone: (847) 564-0822
Approximate (ZIP-level) locationGet directions
Mailing address
85 Revere Dr
Northbrook, IL 60062-8001
Registry dates
- Enumerated
- 2014-12-23
- Last updated
- 2014-12-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.