Provider First Line Business Practice Location Address:
3010 GRAND AVE
Provider Second Line Business Practice Location Address:
CHILD AND ADOLESCENT BEHAVIORAL SERVICES
Provider Business Practice Location Address City Name:
WAUKEGAN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60085
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-377-8950
Provider Business Practice Location Address Fax Number:
414-266-3735
Provider Enumeration Date:
08/23/2006