Provider First Line Business Practice Location Address:
14 HEALTH SERVICES DR
Provider Second Line Business Practice Location Address:
C/O FAMILY SERVICE AGENCY OF DEKALB COUNTY
Provider Business Practice Location Address City Name:
DEKALB
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60115-9637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-758-8616
Provider Business Practice Location Address Fax Number:
815-758-8159
Provider Enumeration Date:
02/10/2012