Organization
WEST GROVE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT WILLIAM GILLIS (ADMINISTRATOR)
(618) 945-2091
Entity
Organization
Contact information
Practice address
RR 1 BOX 417, LAWRENCEVILLE, IL 62439-9796
(618) 943-7597
(618) 943-3218
Mailing address
RR 1 BOX 417, LAWRENCEVILLE, IL 62439-9796
(618) 943-7597
(618) 943-3218
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
0033548
IL
Other
Enumeration date
03/16/2007
Last updated
08/22/2020
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