Organization
MASON'S PLACE TOO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRENA MCCOY (CEO/PARTNER)
(618) 489-1129
Entity
Organization
Contact information
Practice address
125 N RUBY LN # 2, FAIRVIEW HEIGHTS, IL 62208-1926
(618) 489-1129
(618) 213-6082
Mailing address
125 N RUBY LN # 2, FAIRVIEW HEIGHTS, IL 62208-1926
(618) 213-6082
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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