NPI 1457483240

Unit 4467 Cottage Complex

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

Practice location

Address: 1000 N Main St, Anna, IL 62906-1652
Phone: (618) 833-5161

Authorised official

Name: Bruce Brown
Title: Reimbursement Officer II
Phone: (618) 833-5161

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1457483240
Entity type: Organization
NPI issued: 9 Mar 2007
Record last updated: 22 Aug 2020

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.