Healthcare Provider Details

I. General information

NPI: 1316877640
Provider Name (Legal Business Name): PRILA PSYCHIATRIC CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 E WESLEY DR STE D
O FALLON IL
62269-6142
US

IV. Provider business mailing address

1003 E WESLEY DR STE D
O FALLON IL
62269-6142
US

V. Phone/Fax

Practice location:
  • Phone: 618-228-2798
  • Fax: 808-204-8397
Mailing address:
  • Phone: 618-228-2798
  • Fax: 808-204-8397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MADELYN HINDIA
Title or Position: OWNER
Credential: APRN
Phone: 636-385-0376