| Children's Home & Aid Society Of Il | |
|
2133 Johnson Rd Granite City IL 62040-3986 | |
| (618) 452-8900 | |
| (618) 452-9062 |
| Full Name | Children's Home & Aid Society Of Il |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2133 Johnson Rd, Granite City, 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 |
|---|---|
| Children's Home & Aid Society Of Il 200 W Monroe St Ste 2100 Chicago IL 60606-5071 Ph: (312) 424-0200 | Children's Home & Aid Society Of Il 2133 Johnson Rd Granite City IL 62040-3986 Ph: (618) 452-8900 |
| NPI Number | 1134311038 |
|---|---|
| Provider Enumeration Date | 08/14/2007 |
| Last Update Date | 07/01/2022 |
| Certification Date | 06/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134311038 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 004236-11 (Illinois) | Primary |
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