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General NPI Number Information
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NPI Number | 1083097166
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Entity Type | Organization
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Legal Business Name | COMMUNITY ADULT DAY CARE
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 4501 MAIN ST
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-2881
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Country | US
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Telephone | 630-968-1060
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Fax |
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Provider Business Mailing Address
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Address Line | 4501 MAIN ST
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-2881
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Country | US
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Telephone | 630-968-1060
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. KAREN A SWANSON
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Credential |
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Telephone | 630-968-1060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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