| NPI | 1700330545 |
|---|---|
| Former Legal Business Name | MACOUPIN COUNTY MENTAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | TRACY HAYNES Manager 217-854-3166 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2022-07-21 |