| Good Samaritan House Of Granite City, Inc | |
|
1825 Delmar Ave Granite City IL 62040-4508 | |
| (618) 876-0607 | |
| Not Available |
| Full Name | Good Samaritan House Of Granite City, Inc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1825 Delmar Ave, Granite City, Illinois |
| Authorized Official Name and Position | Latosha R Davis (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6182199513 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Samaritan House Of Granite City, Inc 1825 Delmar Ave Granite City IL 62040-4508 Ph: (618) 876-0607 | Good Samaritan House Of Granite City, Inc 1825 Delmar Ave Granite City IL 62040-4508 Ph: (618) 876-0607 |
| NPI Number | 1134612054 |
|---|---|
| Provider Enumeration Date | 06/14/2018 |
| Last Update Date | 06/14/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134612054 | NPI | - | NPPES |
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