Provider Demographics
NPI:1437669926
Name:REMINGTON RECOVERY CENTER, INC.
Entity Type:Organization
Organization Name:REMINGTON RECOVERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSAFO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-208-0270
Mailing Address - Street 1:215 REMINGTON BLVD STE G2
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-3663
Mailing Address - Country:US
Mailing Address - Phone:630-226-0162
Mailing Address - Fax:630-226-0160
Practice Address - Street 1:215 REMINGTON BLVD STE G2
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-3663
Practice Address - Country:US
Practice Address - Phone:630-226-0162
Practice Address - Fax:630-226-0160
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REMINGTON RECOVERY CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-4169-0001-A324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Single Specialty