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Organization

ANIT CARE SERVICES OF ILLINOIS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DONTE DORSEY (PRESIDENT)
(618) 971-3332
Entity
Organization

Contact information

Practice address
10 BRANDONWOOD DR, O FALLON, IL 62269-1208
(618) 971-3332
Mailing address
10 BRANDONWOOD DR, O FALLON, IL 62269-1208

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
251S00000X
Community/Behavioral Health Agency
253J00000X
Foster Care Agency
253Z00000X
In Home Supportive Care Agency
310400000X
Assisted Living Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
06/18/2018
Last updated
06/18/2018
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