Organization
KEY AUTISM SERVICES IL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK HARPER (DIR OF OPERATIONS)
(857) 829-4040
Entity
Organization
Contact information
Practice address
100 ILLINOIS ST STE 200, ST CHARLES, IL 60174-1867
(857) 829-4040
Mailing address
1385 HWY 35 # 284, MIDDLETOWN, NJ 07748-2012
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/31/2019
Last updated
06/29/2023
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