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Organization
YOUTH FARM INC
Active
Organization
YOUTH FARM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM PHILLIPS MDIV PHD LCPC (EXECUTIVE DIRECTOR)
(309) 697-4555
Entity
Organization
Contact information
Practice address
7225 PLANK RD, PEORIA, IL 61604-5296
(309) 697-4555
(309) 697-4033
Mailing address
7225 PLANK RD, PEORIA, IL 61604-5296
(309) 697-4555
(309) 697-4033
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
02285710
IL
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
02285710
IL
Other
Enumeration date
03/17/2006
Last updated
09/11/2025
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