Organization · NPI-2

Clayton Residential Homes INC

Intermediate Care Facility, Mental Illness · Chicago, IL

NPI number1497783872
StatusActive
Last updated in NPPESJul 26, 2016

Details

NPI
1497783872
Entity type
Organization (NPI-2)
Legal business name
Clayton Residential Homes INC
Organization subpart
No
Enumeration date
Jun 28, 2006
Last updated
Jul 26, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
310500000X Intermediate Care Facility, Mental Illness0016634ILYes

Practice location

2026 N Clark St
Chicago, IL 60614-4764

Phone 773-549-1840 · Fax 773-549-2036

Mailing address

465 Central Ave
Suite 100
Northfield, IL 60093-3045

Phone 847-441-8200 · Fax 847-441-0800

Authorized official

Richard Dean Duros
Cfo Coo
8474418200

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