Organization Name: | CHADDOCK |
NPI Number: | 1033157748 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LINDA HARCHARICK (DIRECTOR OF FINANCE & TECHNOLOGY) |
Mailing Address: | 205 S 24th St Quincy |
State: | IL US |
Postal Code: | 623014446 |
Phone Number: | 2172220034 |
Fax Number: | 2172223865 |
NPI Enumeration Date: | 06/03/2006 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | 308658-03 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |