Organization · Type 2 NPI

Maryville Academy

Mental Illness Community Based Residential Treatment Facility · Chicago, IL

NPI number 1508174749 Active

Practice location

1658 W Grand Ave
Chicago, IL 60622-6309

Call (312) 491-3500 Map

Mailing address

1150 N River Rd
Des Plaines, IL 60016-1214

Specialties and licenses

Taxonomy	Code	License
Mental Illness Community Based Residential Treatment Facility Primary	320800000X	None listed

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

2 other providers at this address

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NPI record

NPI: 1508174749
Entity type: Organization (Type 2)
Issued: Sep 22, 2010
Last updated: Jul 8, 2022
Status: Active

Other names

<unavail>
Maryville Madden Shelter · other name
Maryville Madden Shelter · other name

Authorized official

Nancy Z Woulfe
Director of Business Development
(847) 294-1910

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1508174749

Maryville Academy's National Provider Identifier is 1508174749, issued on Sep 22, 2010. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Chicago, IL. The record was last updated on Jul 8, 2022.