Maryville Academy
Clinic/Center, Mental Health (Including Community Mental Health Center) in Berwyn, IL. Organization (NPI-2).
NPI number1427710722
StatusActive
Last updated in NPPESJul 19, 2022
Details
- NPI
- 1427710722
- Entity type
- Organization (NPI-2)
- Legal business name
- Maryville Academy
- Organization subpart
- No
- Enumeration date
- Oct 13, 2021
- Certification date
- Jul 8, 2022
- Last updated
- Jul 19, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | – | – |
Practice location
St. Mary Of Celle1431 Euclid Avenue
Berwyn, IL 60402
Phone 630-736-7480
Mailing address
1150 N River RdDes Plaines, IL 60016-1214
Phone 847-294-1910
Authorized official
Nancy Z Woulfe
Director Of Business Development
8472941910
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