0014 Elisabeth Ludeman Center
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Park Forest, IL. Organization (NPI-2).
NPI number1841320702
StatusActive
Last updated in NPPESJun 13, 2008
Details
- NPI
- 1841320702
- Entity type
- Organization (NPI-2)
- Legal business name
- 0014 Elisabeth Ludeman Center
- Organization subpart
- No
- Enumeration date
- Mar 7, 2007
- Last updated
- Jun 13, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | IL | Yes |
Other names
- State Of Illinois (Other Name)
Practice location
114 N Orchard DrPark Forest, IL 60466-1200
Phone 708-283-3000 · Fax 708-283-3020
Mailing address
114 N Orchard DrPark Forest, IL 60466-1200
Phone 708-283-3000 · Fax 708-283-3020
Authorized official
David I Decker
Center Director
7082833001
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