Individual provider · Type 1 NPI
Lashae Campbell
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Bolingbrook, IL
Practice location
3 Wildwood Lane G
Bolingbrook, IL 60440-1942
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None listed |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
About NPI 1629531561
Lashae Campbell's National Provider Identifier is 1629531561, issued on Apr 8, 2019. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Bolingbrook, IL. The record was last updated on Apr 8, 2019.