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Lashae Campbell
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Bolingbrook, Illinois
NPI 1629531561

Lashae Campbell is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Bolingbrook, IL. Lashae Campbell practices in Bolingbrook, IL. The NPI Number for Lashae Campbell is 1629531561 and holds a License No. (Illinois).

The current practice location address for Lashae Campbell is 3 Wildwood Lane G, Bolingbrook, IL and can be reached out via phone at 708-916-1128.

Location: 3 Wildwood Lane G, Bolingbrook, IL, 60440-1942
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629531561
Provider Name
Lashae Campbell
Credential
Provider Entity Type
Individual
Gender
Female
Address
3 Wildwood Lane G, Bolingbrook, IL, 60440-1942
Phone Number
708-916-1128
Fax Number
Provider Enumeration Date
04/08/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3 Wildwood Lane G
City
Bolingbrook
State
Illinois
Zip
60440-1942
Phone Number
708-916-1128
Fax Number
person
Provider Business Mailing Address Details
Address
3 Wildwood Lane G
City
Bolingbrook
State
Illinois
Zip
60440-1942
Phone Number
708-916-1128
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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