MARYVILLE ACADEMY NPI 1962711218

NPI Information

NPI: 1962711218
Provider Name: MARYVILLE ACADEMY

Other Name: ST. GEORGE

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
1150 N RIVER RD
DES PLAINES, IL
ZIP 60016
Phone: (847) 294-1999
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MARYVILLE ACADEMY is a mental health (including community mental health center) clinic center in Des Plaines, IL. MARYVILLE ACADEMY NPI is 1962711218. The provider is registered as an organization entity type.
The provider Other Name Is St. George.

The provider's business location address is:

1150 N RIVER RD
DES PLAINES, IL
ZIP 60016-214
Phone: (847) 294-1999
Fax: (847) 294-2892

The provider's authorized official is Nancy Z Woulfe .
The authorized official title is Director Of Business Development and has the following contact phone number (847) 294-1910.

The enumeration date for this NPI number is 10/5/2010 and was last updated on 7/8/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities			ILLINOIS	No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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