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NPI Code Detail

MEDICARE: KENNETH YOUNG CENTER

MEDICARE: KENNETH YOUNG CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1629083241
Entity Type Code : Organization
Provider Name (Legal Business Name) : KENNETH YOUNG CENTER
Provider Business Mailing Address
First Line : 1001 ROHLWING RD
Second Line :
City : ELK GROVE VILLAGE
State : IL
Zip : 60007-3217
Country : US
Telephone Number : 847-524-8800
Fax Number : 847-524-8824
Provider Business Practice Location Address
First Line : 1001 ROHLWING RD
Second Line :
City : ELK GROVE VILLAGE
State : IL
Zip : 60007-3217
Country : US
Telephone Number : 847-524-8800
Fax Number : 847-524-8824
Authorized Official
Title or Position : HUMAN RESOURCES MANAGER
Name : JAMES BRUSKI
Credential :
Telephone Number : 847-524-8800
Provider Enumeration Date : 07/30/2006
Last Update Date : 08/10/2017

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Directions to “KENNETH YOUNG CENTER ” Practice Location

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