Organization
PATTERSON HOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HASELEY (OFFICE MANAGER)
(217) 422-6510
Entity
Organization
Contact information
Practice address
522 S BROAD ST, CARLINVILLE, IL 62626-2114
(217) 930-2135
Mailing address
636 W IMBODEN DR, DECATUR, IL 62521-9067
(217) 422-6510
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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