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Organization
MENDED HEARTS STABLE
Active
Organization
MENDED HEARTS STABLE
Active
Other names
Mended Hearts Stable, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE ELISE SELLNER LCPC (EXECUTIVE DIRECTOR)
(309) 383-4323
Entity
Organization
Contact information
Practice address
1431 LOURDES RD, METAMORA, IL 61548-7609
(309) 383-4323
(309) 383-3399
Mailing address
1431 LOURDES RD, METAMORA, IL 61548-7609
(309) 383-4323
(309) 383-3399
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
180005723
IL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/03/2008
Last updated
07/10/2024
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