Organization
HUMAN SERVICE CENTER OF SOUTHERN METRO-EAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BUATTE (EXECUTIVE DIRECTOR)
(618) 282-6233
Entity
Organization
Contact information
Practice address
10257 STATE ROUTE 3, RED BUD, IL 62278-4418
(618) 282-6233
(618) 282-6220
Mailing address
10257 STATE ROUTE 3, RED BUD, IL 62278-4418
(618) 282-6233
(618) 282-6220
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
193200000X
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134199037
—
IL
Enumeration date
02/14/2014
Last updated
02/14/2014
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