Organization
HUMAN SUPPORT SERVICES
Active
Organization
HUMAN SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA JONES (BILLING MANAGER)
(618) 939-4444
Entity
Organization
Contact information
Practice address
988 N ILLINOIS ROUTE 3, WATERLOO, IL 62298-1059
(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
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
A-0112-0001-A
IL
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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