MARYVILLE ACADEMY NPI 1902353782

NPI Information

NPI: 1902353782
Provider Name: MARYVILLE ACADEMY

Doing Business As: FAMILY BEHAVIORAL HEALTH CLINIC

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
1658 W GRAND AVE
CHICAGO, IL
ZIP 60622
Phone: (312) 491-3530
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MARYVILLE ACADEMY is a mental health (including community mental health center) clinic center in Chicago, IL. MARYVILLE ACADEMY NPI is 1902353782. The provider is registered as an organization entity type.
The provider Is Doing Business As Family Behavioral Health Clinic.

The provider's business location address is:

1658 W GRAND AVE
CHICAGO, IL
ZIP 60622-309
Phone: (312) 491-3530

The provider's authorized official is Nancy Z Woulfe .
The authorized official title is Director Of Business Development and has the following contact phone number (847) 294-1910.

The enumeration date for this NPI number is 9/8/2016 and was last updated on 7/11/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No
2	261QM0850X	Clinic/Center	Adult Mental Health	No
3	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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