Wm. W. Fox Developmental Center 2c

NPI #1710021696 in Dwight, Illinois

Provider Information

NPI Number: 1710021696
Entity Type: Organization
Organization Name: Wm. W. Fox Developmental Center 2c
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 16, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 134 W MAIN ST
City: Dwight
State: Illinois
ZIP Code: 60420-1322
Phone: (815) 584-3347

Authorized Official

Name: DR. GUS PEDRAZA
Title: MEDICAL DIRECTOR
Phone: (815) 584-3347

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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