Willowglen Academy-Illinois INC

NPI #1215441050 in Freeport, Illinois

Provider Information

NPI Number: 1215441050
Entity Type: Organization
Organization Name: Willowglen Academy-Illinois INC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Nov 30, 2017
Last Updated: Nov 30, 2017

Practice Location

Address: 701 W LAMM RD
City: Freeport
State: Illinois
ZIP Code: 61032-9630
Phone: (815) 233-6162

Authorized Official

Name: ELIZABETH A KINARD
Title: EXECUTIVE DIRECTOR
Phone: (815) 262-5254

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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