Organization
BEVERLY FARM LIVING OPTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARTHA A. WARFORD (EXECUTIVE DIRECTOR)
(618) 466-0367
Entity
Organization
Contact information
Practice address
6301 HUMBERT RD, GODFREY, IL 62035-2163
(618) 466-0367
(618) 466-3652
Mailing address
6301 HUMBERT RD, GODFREY, IL 62035-2163
(618) 466-0367
(618) 466-3652
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
201300002M
IL
Other
Enumeration date
12/26/2013
Last updated
12/26/2013
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