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Glenwood House Residential Care, Inc.
Intellectual Disabilities Intermediate Care Facility in Streator, Illinois
NPI 1205014727

Glenwood House Residential Care, Inc. is a Intellectual Disabilities Intermediate Care Facility based in Streator, IL. Glenwood House Residential Care, Inc. practices in Streator, IL. The NPI Number for Glenwood House Residential Care, Inc. is 1205014727 and holds a License No. 0037192 (Illinois).

The current practice location address for Glenwood House Residential Care, Inc. is 300 W 12Th St, Streator, IL and can be reached out via phone at 815-673-1182 and via fax at 815-673-3231.

Location: 300 W 12Th St, Streator, IL, 61364-3301
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1205014727
Provider Name
Glenwood House Residential Care, Inc.
Credential
Provider Entity Type
Organization
Address
300 W 12Th St, Streator, IL, 61364-3301
Phone Number
815-673-1182
Fax Number
815-673-3231
Provider Enumeration Date
02/06/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0037192 01 IL STATE LICENSE NUMBER
institution
Provider Business Practice Location Address Details
Address
300 W 12Th St
City
Streator
State
Illinois
Zip
61364-3301
Phone Number
815-673-1182
Fax Number
815-673-3231
person
Provider Business Mailing Address Details
Address
300 W 12Th St
City
Streator
State
Illinois
Zip
61364-3301
Phone Number
815-673-1182
Fax Number
815-673-3231
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
0037192 (Illinois)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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