Elece Douglas
NPI #1578898649 in Hazel Crest, Illinois
Provider Information
- NPI Number
- 1578898649
- Entity Type
- Organization
- Organization Name
- Elece Douglas
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Oct 7, 2009
- Last Updated
- Oct 7, 2009
Practice Location
- Address
- 17309 HOLMES AVE
- City
- Hazel Crest
- State
- Illinois
- ZIP Code
- 60429-1710
- Phone
- (708) 335-3519
Authorized Official
- Name
- ELECE DOUGLAS
- Title
- DEVELOMENTAL THERAPIST
- Phone
- (708) 335-3519
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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