Organization
CHADDOCK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN PATTON (DIRECTOR OF FINANCE)
(217) 592-0317
Entity
Organization
Contact information
Practice address
205 S 24TH ST, QUINCY, IL 62301-4446
(217) 222-0034
(217) 222-3865
Mailing address
205 S 24TH ST, QUINCY, IL 62301-4446
(217) 222-0034
(217) 222-3865
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
004049-10
IL
320800000X
Mental Illness Community Based Residential Treatment Facility
308658-03
IL
Other
Enumeration date
06/03/2006
Last updated
06/22/2023
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