Provider Demographics
NPI:1891887030
Name:MENTAL HEALTH AND DEAFNESS RESOURCES, INC.
Entity Type:Organization
Organization Name:MENTAL HEALTH AND DEAFNESS RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-509-8260
Mailing Address - Street 1:614 ANTHONY TRL
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2540
Mailing Address - Country:US
Mailing Address - Phone:847-509-8260
Mailing Address - Fax:847-509-8157
Practice Address - Street 1:614 ANTHONY TRL
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2540
Practice Address - Country:US
Practice Address - Phone:847-509-8260
Practice Address - Fax:847-509-8157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
273R00000X
IL381801320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No273R00000XHospital UnitsPsychiatric Unit