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Glen Brook
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Vienna, Illinois
NPI 1629292081

Glen Brook is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Vienna, IL. Glen Brook practices in Vienna, IL. The NPI Number for Glen Brook is 1629292081 and holds a License No. (Illinois).

The current practice location address for Glen Brook is 801 North 1St Street, Vienna, IL and can be reached out via phone at 618-658-2005.

Location: 801 North 1St Street, Vienna, IL, 62995-1544
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1629292081
Provider Name
Glen Brook
Credential
Provider Entity Type
Organization
Address
801 North 1St Street, Vienna, IL, 62995-1544
Phone Number
618-658-2005
Fax Number
Provider Enumeration Date
04/13/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
801 North 1St Street
City
Vienna
State
Illinois
Zip
62995-1544
Phone Number
618-658-2005
Fax Number
person
Provider Business Mailing Address Details
Address
801 North 1St Street
City
Vienna
State
Illinois
Zip
62995-1544
Phone Number
618-658-2005
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
(Illinois)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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