Organization
PROJECT OZ
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERIS LARSON LCSW (DIRECTOR OF YOUTH SERVICES)
(309) 827-0377
Entity
Organization
Contact information
Practice address
1105 W FRONT ST, BLOOMINGTON, IL 61701-4853
(309) 827-0377
(309) 829-8877
Mailing address
1105 W FRONT ST, BLOOMINGTON, IL 61701-4853
(309) 827-0377
(309) 829-8877
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/06/2024
Last updated
01/09/2025
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