Organization
HUMAN SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA JONES (BUSINESS MANAGER)
(618) 939-4444
Entity
Organization
Contact information
Practice address
988 N ILLINOIS ROUTE 3, WATERLOO, IL 62298-1059
(619) 393-4444
Mailing address
PO BOX 146, WATERLOO, IL 62298-0146
(619) 393-4444
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
Other
Enumeration date
12/10/2018
Last updated
12/10/2018
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