Ann Kiley Developmental Center Unit 3362 Home 22

NPI #1982732905 in Waukegan, Illinois

Provider Information

NPI Number: 1982732905
Entity Type: Organization
Organization Name: Ann Kiley Developmental Center Unit 3362 Home 22
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Mar 1, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1401 W DUGDALE RD
City: Waukegan
State: Illinois
ZIP Code: 60085-6263
Phone: (847) 249-0600

Authorized Official

Name: DR. PRATHBA MALHOTRA, M.D.
Title: MEDICAL DIRECTOR
Phone: (847) 249-0600

Specialties & Taxonomy Codes

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

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