Organization Name: | TRADE INDUSTRIES |
NPI Number: | 1346378312 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK A AUTEN (VICE PRESIDENT) |
Mailing Address: | Route 14 East Mc Leansboro |
State: | IL US |
Postal Code: | 628590070 |
Phone Number: | 6186434321 |
Fax Number: | 6186434230 |
NPI Enumeration Date: | 03/01/2007 |
NPI Last Update Date: | 10/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | 0491 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |