NPI 1003262254

Patterson House INC

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Carlinville, IL

Practice location

Address: 717 E 1st South St, Carlinville, IL 62626-1922
Phone: (217) 930-2166
Mailing address: 636 W Imboden Dr, Decatur, IL 62521-9067

Authorised official

Name: Jennifer Haseley
Title: Office Manager
Phone: (217) 422-6510

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1003262254
Entity type: Organization
NPI issued: 6 May 2016
Record last updated: 6 May 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.