Organization
SOJOURN HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVE MANSON MS, CADC, MISA 1 (EXECUTIVE DIRECTOR)
(815) 232-5121
Entity
Organization
Contact information
Practice address
565 N TURNER AVE, FREEPORT, IL 61032-3252
(815) 232-5121
(815) 233-4591
Mailing address
565 N TURNER AVE, FREEPORT, IL 61032-3252
(815) 232-5121
(815) 233-4591
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
A-0595-0001-A
IL
Other
Enumeration date
02/09/2016
Last updated
02/09/2016
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