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Organization

HUMAN SUPPORT SERVICES

Active
Parent organization
HUMAN SUPPORT SERVICES
Organization subpart
Yes

Provider details

NPI number
Legal business name
HUMAN SUPPORT SERVICES
Authorized official
MR. ROBERT COLE (EXECUTIVE DIRECTOR)
(618) 939-4444
Entity
Organization

Contact information

Practice address
224 N MAIN ST REAR, WATERLOO, IL 62298-1264
(618) 939-4444
(618) 939-4181
Mailing address
PO BOX 146, WATERLOO, IL 62298-0146
(618) 939-4444
(618) 939-4181

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06715560
BCBS
IL
01
10B862
BCBS
MO
Enumeration date
09/26/2013
Last updated
09/26/2013
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