Organization
LIVING IN A FAMILY ENVIRONMENT MANAGEMENT CORPORATION
Active
Other names
Living In A Family Environment Management Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT STANLEY BUFFINGTON (C.E.O.)
(618) 967-7106
Entity
Organization
Contact information
Practice address
3136 MYERS LN, MAKANDA, IL 62958-5200
(618) 967-7106
(618) 549-8163
Mailing address
3136 MYERS LN, MAKANDA, IL 62958-5200
(618) 967-7106
(618) 549-8163
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
201300019S
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201300019S
—
IL
Enumeration date
09/27/2006
Last updated
03/30/2016
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