Provider Demographics
NPI:1154454775
Name:KANKAKEE COUNTY TRAINING CENTER FOR THE DISABLED, INC.
Entity Type:Organization
Organization Name:KANKAKEE COUNTY TRAINING CENTER FOR THE DISABLED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REHAB. COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:SAINDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-932-4022
Mailing Address - Street 1:333 S SCHUYLER AVE
Mailing Address - Street 2:
Mailing Address - City:BRADLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60915-2341
Mailing Address - Country:US
Mailing Address - Phone:815-932-4022
Mailing Address - Fax:815-932-2131
Practice Address - Street 1:333 S SCHUYLER AVE
Practice Address - Street 2:
Practice Address - City:BRADLEY
Practice Address - State:IL
Practice Address - Zip Code:60915-2341
Practice Address - Country:US
Practice Address - Phone:815-932-4022
Practice Address - Fax:815-932-2131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251C00000X, 320900000X, 347B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Not Answered347B00000XTransportation ServicesBus
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILHSD02903OtherROCS