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Organization

CENTERSTONE OF ILLINOIS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STACY PHILLIPS (ACCOUNTS RECEIVEABLE DEPT MANAGER)
(618) 937-6483
Entity
Organization

Contact information

Practice address
2302 STATE ST, ALTON, IL 62002-4379
(618) 937-6483
Mailing address
2302 STATE ST, ALTON, IL 62002-4379

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
320800000X
Mental Illness Community Based Residential Treatment Facility

Other

Enumeration date
01/11/2016
Last updated
03/17/2021
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