Organization
COORDINATED YOUTH AND HUMAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BOBBIE SMITH (EXECUTIVE DIRECTOR)
(618) 876-2383
Entity
Organization
Contact information
Practice address
2016 MADISON AVE, GRANITE CITY, IL 62040-4657
(618) 876-2383
(618) 876-4952
Mailing address
2016 MADISON AVE, GRANITE CITY, IL 62040-4657
(618) 876-2383
(618) 876-4952
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
05/21/2014
Last updated
11/18/2021
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