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General NPI Number Information
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NPI Number | 1306431960
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Entity Type | Organization
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Legal Business Name | ORCHARD VILLAGE
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Dates
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Enumeration Date | 03/05/2021
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 7620 GROSS POINT RD
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City | SKOKIE
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State | IL
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Zip | 60077-2612
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Country | US
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Telephone | 847-967-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 7660 GROSS POINT RD
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City | SKOKIE
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State | IL
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Zip | 60077-2613
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Country | US
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Telephone | 847-967-1800
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Fax |
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Authorized Official
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Title or Position | CFO & EVP
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Name | MARLENE ZIELONKA HODGES
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Credential |
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Telephone | 847-583-7731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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