MARYVILLE ACADEMY NPI 1003341058

NPI Information

NPI: 1003341058
Provider Name: MARYVILLE ACADEMY

Doing Business As: FAMILY BEHAVIORAL HEALTH CLINIC

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
1658 W GRAND AVE
CHICAGO, IL
ZIP 60622
Phone: (312) 491-3530
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MARYVILLE ACADEMY is a rehabilitation and substance use disorder clinic center in Chicago, IL. MARYVILLE ACADEMY NPI is 1003341058. 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 Sr. Catherine Ryan .
The authorized official title is Executive Director and has the following contact phone number (847) 294-1893.

The enumeration date for this NPI number is 4/27/2017 and was last updated on 5/12/2021.

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	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			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: 11/14/2023

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