Organization
COMWELL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY BAUER (IT COORDINATOR)
(618) 282-6233
Entity
Organization
Contact information
Practice address
10257 STATE ROUTE 3, RED BUD, IL 62278-4418
(618) 282-6233
(618) 282-6949
Mailing address
10257 STATE ROUTE 3, RED BUD, IL 62278-4418
(618) 282-6233
(618) 282-6949
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
01/24/2006
Last updated
02/03/2021
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