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Organization

HOMESTEAD HOUSE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WILLIAM JAMES MATTINGLY (PARTNER ADMINISTRATOR)
(618) 985-8351
Entity
Organization

Contact information

Practice address
905 NORTH JEFFERSON, WEST FRANKFORT, IL 62896
(618) 932-2725
(618) 932-2660
Mailing address
1120 NORTH DIVISION STREET, CARTERVILLE, IL 62918
(618) 985-8351
(618) 985-8817

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
IL

Other

Enumeration date
08/01/2007
Last updated
04/20/2008
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