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General NPI Number Information
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NPI Number | 1154796068
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Entity Type | Organization
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Legal Business Name | SYLVIA HOMES, INC.
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Dates
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Enumeration Date | 12/03/2015
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 1093 CREEKSIDE CT 2B
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City | WHEELING
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State | IL
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Zip | 60090-5414
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Country | US
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Telephone | 847-902-6729
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Fax |
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Provider Business Mailing Address
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Address Line | 1093 CREEKSIDE CT 2B
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City | WHEELING
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State | IL
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Zip | 60090-5414
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Country | US
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Telephone | 847-902-6729
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEXANDER TOSA
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Credential |
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Telephone | 847-902-6729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 201100002C
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License Number State | IL
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