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General NPI Number Information
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NPI Number | 1902358591
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Entity Type | Organization
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Legal Business Name | ROAD 2 RECOVERY COMMUNITY SERVICES, INC.
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Dates
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Enumeration Date | 10/29/2016
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Last Update Date | 10/29/2016
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Provider Practice Location Address
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Address Line | 21020 S 80TH AVE
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City | FRANKFORT
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State | IL
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Zip | 60423-9186
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Country | US
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Telephone | 815-600-8035
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Fax | 815-600-8036
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Provider Business Mailing Address
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Address Line | 21020 S 80TH AVE
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City | FRANKFORT
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State | IL
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Zip | 60423-9186
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Country | US
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Telephone | 815-600-8035
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Fax | 815-600-8036
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHRISTINA ELAINE CURTIS
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Credential |
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Telephone | 773-615-6936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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