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Tiffany Kragenbrink
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Rockton, Illinois
NPI 1720578503

Tiffany Kragenbrink is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Rockton, IL. Tiffany Kragenbrink practices in Rockton, IL. The NPI Number for Tiffany Kragenbrink is 1720578503 and holds a License No. (Illinois).

The current practice location address for Tiffany Kragenbrink is 58 W Rockton Rd, Rockton, IL and can be reached out via phone at 815-624-8431.

Location: 58 W Rockton Rd, Rockton, IL, 61072-1699
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1720578503
Provider Name
Tiffany Kragenbrink
Credential
Provider Entity Type
Individual
Gender
Female
Address
58 W Rockton Rd, Rockton, IL, 61072-1699
Phone Number
815-624-8431
Fax Number
Provider Enumeration Date
05/16/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
58 W Rockton Rd
City
Rockton
State
Illinois
Zip
61072-1699
Phone Number
815-624-8431
Fax Number
person
Provider Business Mailing Address Details
Address
58 W Rockton Rd
City
Rockton
State
Illinois
Zip
61072-1699
Phone Number
815-624-8431
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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