Provider Demographics
NPI:1336319672
Name:THE LARKIN CENTER
Entity Type:Organization
Organization Name:THE LARKIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRAF
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:847-695-5656
Mailing Address - Street 1:1212 LARKIN AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-6042
Mailing Address - Country:US
Mailing Address - Phone:847-695-5656
Mailing Address - Fax:847-695-0897
Practice Address - Street 1:515 SPORTS WAY DRIVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123
Practice Address - Country:US
Practice Address - Phone:847-888-9590
Practice Address - Fax:847-888-9678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL38443402033068251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL00465172033048OtherDCFS CONTRACT
IL01578872033048OtherDCFS CONTRACT
IL24728372033048OtherDCFS CONTRACT
IL38443402033068OtherDCFS CONTRACT
IL00954672033048OtherDCFS CONTRACT
IL21335772033048OtherDCFS CONTRACT
IL02116072013018OtherDCFS CONTRACT