COVENANT ENABLING RESIDENCES OF ILLINOIS is an intermediate care facility mentally retarded in Oak Forest, IL. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. COVENANT ENABLING RESIDENCES OF ILLINOIS NPI is 1659559292. The provider is registered as an organization entity type.
The provider's business location address is:
15841 TERRACE DR
OAK FOREST, IL
ZIP 60452-911
Phone: (708) 687-2038
Fax: (708) 687-2762
The provider's authorized official is Julie A. Smith .
The authorized official title is Administrative Coordinator and has the following contact phone number (708) 687-2038.
The CLIA number assigned to this NPI record is 14D2236535 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 2/6/2008 and was last updated on 2/6/2008.