| NPI | 1477286516 |
|---|---|
| Other Name | LOCUST STREET RESOURCE CENTER - CHERRY ST |
| Entity Type | Organization |
| Authorized Contact | SALLY MAGUIRE Credentialing Clerk 217-854-3166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2022-07-06 |