Provider Demographics
NPI:1447284393
Name:THE LARKIN CENTER
Entity type:Organization
Organization Name:THE LARKIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRAF
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:847-695-5656
Mailing Address - Street 1:1212 LARKIN AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-6042
Mailing Address - Country:US
Mailing Address - Phone:847-695-5656
Mailing Address - Fax:847-695-0897
Practice Address - Street 1:1212 LARKIN AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-6042
Practice Address - Country:US
Practice Address - Phone:847-695-5656
Practice Address - Fax:847-695-0897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL012161-10251B00000X, 320800000X, 322D00000X, 323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Not Answered322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Not Answered323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21335772033047Medicaid
IL38443402033067Medicaid
IL01216072013017Medicaid
IL00465172033047Medicaid
IL00954672033047Medicaid
IL24728372033047Medicaid
IL01578872033047Medicaid