Organization
TRANSITIONS OF WESTERN ILLINOIS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICKIE STULL (INFORMATION SERVICES SPECIALIST)
(217) 223-0423
Entity
Organization
Contact information
Practice address
4409 MAINE ST, QUINCY, IL 62305-5849
(217) 223-0413
Mailing address
4409 MAINE ST, QUINCY, IL 62305-5849
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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