Organization
PATTERSON HOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HASELEY (OFFICE MANAGER)
(217) 422-6510
Entity
Organization
Contact information
Practice address
717 E 1ST SOUTH ST, CARLINVILLE, IL 62626-1922
(217) 930-2166
Mailing address
636 W IMBODEN DR, DECATUR, IL 62521-9067
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/06/2016
Last updated
05/06/2016
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