Organization
SOUTHEASTERN RESIDENTIAL ALTERNATIVES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT CAPE (PRESIDENT OF THE BOARD)
(618) 272-5007
Entity
Organization
Contact information
Practice address
125 W CLARK ST, HARRISBURG, IL 62946-2738
(618) 272-5007
(618) 272-3091
Mailing address
PO BOX 465, HARRISBURG, IL 62946-0465
(618) 272-5007
(618) 272-3091
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/17/2015
Last updated
12/17/2015
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