Organization
CATHOLIC CHILDRENS HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN E ROACH (EXECUTIVE DIRECTOR)
(217) 523-9201
Entity
Organization
Contact information
Practice address
1400 STATE ST, ALTON, IL 62002
(618) 465-3594
(618) 465-4023
Mailing address
1400 STATE ST, ALTON, IL 62002
(618) 465-3594
(618) 465-4023
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
00397410
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3BOOIPI033
—
IL
Enumeration date
05/03/2006
Last updated
08/22/2020
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