Provider Demographics
NPI:1073692315
Name:COMMUNITY RESOURCES FOR EDUCATION AND WELLNESS, INC
Entity Type:Organization
Organization Name:COMMUNITY RESOURCES FOR EDUCATION AND WELLNESS, INC
Other - Org Name:CREW, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:RIVERS
Authorized Official - Suffix:
Authorized Official - Credentials:MS CRADC
Authorized Official - Phone:847-872-2830
Mailing Address - Street 1:2800 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:ZION
Mailing Address - State:IL
Mailing Address - Zip Code:60099
Mailing Address - Country:US
Mailing Address - Phone:847-872-2830
Mailing Address - Fax:847-872-7861
Practice Address - Street 1:2800 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:ZION
Practice Address - State:IL
Practice Address - Zip Code:60099
Practice Address - Country:US
Practice Address - Phone:847-872-2830
Practice Address - Fax:847-872-7861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA28000001A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health