| Childrens Home & Aid Soc Of Il | |
|
907 Martin Luther King Dr Suite C East Saint Louis IL 62201-1704 | |
| (618) 874-0216 | |
| Not Available |
| Full Name | Childrens Home & Aid Soc Of Il |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 907 Martin Luther King Dr, East Saint Louis, Illinois |
| Authorized Official Name and Position | Mike Shaver (PRESIDENT/CEO) |
| Authorized Official Contact | 3124246801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Home & Aid Soc Of Il 200 W Monroe St Ste 2100 Chicago IL 60606-5071 Ph: (312) 424-0200 | Childrens Home & Aid Soc Of Il 907 Martin Luther King Dr Suite C East Saint Louis IL 62201-1704 Ph: (618) 874-0216 |
| NPI Number | 1346557170 |
|---|---|
| Provider Enumeration Date | 08/31/2010 |
| Last Update Date | 07/01/2022 |
| Certification Date | 06/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346557170 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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