Provider Demographics
NPI:1790232981
Name:TK BEHAVIORAL, LLC
Entity Type:Organization
Organization Name:TK BEHAVIORAL, LLC
Other - Org Name:TIMBERLINE KNOLLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP AND SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-861-6000
Mailing Address - Street 1:40 TIMBERLINE DR
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-3848
Mailing Address - Country:US
Mailing Address - Phone:630-257-9600
Mailing Address - Fax:
Practice Address - Street 1:14620 S LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-2544
Practice Address - Country:US
Practice Address - Phone:630-343-2336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center