Provider Demographics
NPI:1578755237
Name:ADULT CHILD & FAMILY SERVICES LLC
Entity Type:Organization
Organization Name:ADULT CHILD & FAMILY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:LILLICH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:262-375-8441
Mailing Address - Street 1:101 FALLS RD
Mailing Address - Street 2:#404
Mailing Address - City:GRAFTON
Mailing Address - State:WI
Mailing Address - Zip Code:53204-2612
Mailing Address - Country:US
Mailing Address - Phone:262-375-8441
Mailing Address - Fax:262-546-0005
Practice Address - Street 1:101 FALLS RD
Practice Address - Street 2:#404
Practice Address - City:GRAFTON
Practice Address - State:WI
Practice Address - Zip Code:53204-2612
Practice Address - Country:US
Practice Address - Phone:262-375-8441
Practice Address - Fax:262-546-0005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health