Organization
WEBSTER-CANTRELL HALL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN S HARRIS (CHIEF EXECUTIVE OFFICER)
(217) 423-6961
Entity
Organization
Contact information
Practice address
1942 E CANTRELL ST, DECATUR, IL 62521-3214
(217) 423-6961
(217) 421-6889
Mailing address
1942 E CANTRELL ST, DECATUR, IL 62521-3214
(217) 423-6961
(217) 421-6889
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
021746-10
IL
Other
Enumeration date
03/17/2006
Last updated
03/24/2016
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