Organization · Type 2 NPI

Illinois Department of Human Services

Intellectual and/or Developmental Disabilities Residential Treatment Facility · Centralia, IL

NPI number 1639214760 Active

Practice location

1535 W Mccord St
Centralia, IL 62801-5805

Call (618) 532-1811 Map

Fax (618) 532-7464

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary 320600000X805-8000 (IL)

Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

13 other providers at this address

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About NPI 1639214760

Illinois Department of Human Services's National Provider Identifier is 1639214760, issued on Feb 20, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Centralia, IL. The record was last updated on Jun 20, 2008.