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NPI 1689124877 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Harvey, IL
Provider details
- NPI number
- 1689124877
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Tara Moore, Ceo(773) 996-4545
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Residential Treatment Facilities
Practice location
125 E 144th Ct
Harvey, IL 60426-1218
Phone: (773) 996-4545
Approximate (ZIP-level) locationGet directions
Mailing address
125 E 144th Ct
Harvey, IL 60426-1218
Registry dates
- Enumerated
- 2016-10-11
- Last updated
- 2016-10-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.