Glen Brook
Glen Brook is an Intellectual and/or Developmental Disabilities Residential Treatment Facility in Vienna, Illinois. Licensed in Illinois. Registered with an NPI since 2007.
- Licensed in
- IL
- In the registry since
- 2007
Practice location Address checks out
801 N 1st StVienna, IL 62995-1544
Phone: (618) 658-2005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Intellectual and/or Developmental Disabilities Residential Treatment Facility (primary) | Taxonomy 320600000X (IL) |
|---|
Record details
| NPI number | 1629292081 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | James Keller — Administrator · (618) 833-5070 |
| NPI enumerated | April 13, 2007 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 801 North 1st Street, Vienna, IL 62995-1544 |