Provider Demographics
NPI:1639519960
Name:FAMILY & FRIENDS ADULT DAY CENTER INC.
Entity Type:Organization
Organization Name:FAMILY & FRIENDS ADULT DAY CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAVERS
Authorized Official - Suffix:
Authorized Official - Credentials:RESP THERAPIST
Authorized Official - Phone:815-557-7010
Mailing Address - Street 1:701 ABE ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60432-1925
Mailing Address - Country:US
Mailing Address - Phone:815-557-7010
Mailing Address - Fax:
Practice Address - Street 1:701 ABE ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-1925
Practice Address - Country:US
Practice Address - Phone:815-557-7010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL305R00000X302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization