Healthcare Provider Details

I. General information

NPI: 1104765122
Provider Name (Legal Business Name): TERESA'S PLACE ADULT DAYCARE CENTER INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 N MAIN ST
GLEN ELLYN IL
60137-3674
US

IV. Provider business mailing address

1183 LONDONBERRY LN
GLEN ELLYN IL
60137-6109
US

V. Phone/Fax

Practice location:
  • Phone: 331-462-9136
  • Fax:
Mailing address:
  • Phone: 331-462-9136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. LATANYA Y OWENS
Title or Position: FOUNDER/EXECUTIVE DIRECTOR
Credential: MBA, MPM, MISM, M.ED
Phone: 331-462-9136