Healthcare Provider Details

I. General information

NPI: 1891060752
Provider Name (Legal Business Name): THE CENTER FOR YOUTH & FAMILY SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2012
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 5TH ST
LINCOLN IL
62656-9115
US

IV. Provider business mailing address

2100 5TH ST
LINCOLN IL
62656-9115
US

V. Phone/Fax

Practice location:
  • Phone: 217-732-5935
  • Fax: 217-735-1738
Mailing address:
  • Phone: 217-732-5935
  • Fax: 217-735-1738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number512961
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE BARISCH
Title or Position: DIRECTOR OF THERAPEUTIC SERVICES
Credential: LCPC
Phone: 309-323-6600