Organization
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Active
Organization
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Active
Other names
Alton Mental Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA PIEPHOFF (HOSPITAL ADMINISTRATOR)
(618) 474-3473
Entity
Organization
Contact information
Practice address
4500 COLLEGE AVE, ALTON, IL 62002
(618) 474-3800
Mailing address
4500 COLLEGE AVE, ALTON, IL 62002-5051
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000194572001
—
IL
Enumeration date
08/01/2006
Last updated
08/21/2018
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