Provider Demographics
NPI:1215776224
Name:HOME OF FRIENDS ILLINOIS
Entity type:Organization
Organization Name:HOME OF FRIENDS ILLINOIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMAR
Authorized Official - Middle Name:C
Authorized Official - Last Name:ADLER BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-430-4555
Mailing Address - Street 1:839 BURTON AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-4607
Mailing Address - Country:US
Mailing Address - Phone:847-430-4555
Mailing Address - Fax:
Practice Address - Street 1:839 BURTON AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-4607
Practice Address - Country:US
Practice Address - Phone:847-430-4555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities