Illinois Mentor Community Services, INC

NPI #1265888440 in Frankfort, Illinois

Provider Information

NPI Number: 1265888440
Entity Type: Organization
Organization Name: Illinois Mentor Community Services, INC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: May 6, 2016
Last Updated: May 6, 2016

Practice Location

Address: 20646 ABBEY WOODS CT N
Address 2: SUITE 201
City: Frankfort
State: Illinois
ZIP Code: 60423-3161
Phone: (815) 464-3239

Authorized Official

Name: SHELLEY HANSEN-BLAKE
Title: EXECUTIVE DIRECTOR
Phone: (608) 427-5945

Specialties & Taxonomy Codes

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

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