Organization
HUMAN SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE RILEY (PRESIDENT & CEO)
(618) 939-4444
Entity
Organization
Contact information
Practice address
266 N MAIN ST, WATERLOO, IL 62298-1250
(618) 939-4444
Mailing address
PO BOX 146, WATERLOO, IL 62298-0146
(618) 939-4444
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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