Provider Demographics
NPI:1215171293
Name:RADIUS FOUNDATION, INC
Entity type:Organization
Organization Name:RADIUS FOUNDATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAMLETT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,CADC,MISA,CADP
Authorized Official - Phone:708-923-0800
Mailing Address - Street 1:11952 S HARLEM AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1167
Mailing Address - Country:US
Mailing Address - Phone:708-923-0800
Mailing Address - Fax:708-923-0700
Practice Address - Street 1:11952 S HARLEM AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1167
Practice Address - Country:US
Practice Address - Phone:708-923-0800
Practice Address - Fax:708-923-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM2800X, 261QR0405X
ILA-4709-0002-A103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadoneGroup - Single Specialty
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder