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NPI Code Detail

MEDICARE: HOYLETON YOUTH AND FAMILY SERVICES

MEDICARE: HOYLETON YOUTH AND FAMILY SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency
2253J00000XFoster Care Agency

General Provider Information

NPI Number : 1932484748
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOYLETON YOUTH AND FAMILY SERVICES
Provider Business Mailing Address
First Line : 350 N MAIN
Second Line :
City : HOYLETON
State : IL
Zip : 62271-0000
Country : US
Telephone Number : 618-493-7382
Fax Number : 618-493-7504
Provider Business Practice Location Address
First Line : 5601 STATE ST
Second Line :
City : EAST SAINT LOUIS
State : IL
Zip : 62203-1346
Country : US
Telephone Number : 618-875-0673
Fax Number : 618-875-0861
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MR. CHRISTOPHER L. COX
Credential : MSW, LCSW
Telephone Number : 618-493-7382
Provider Enumeration Date : 10/13/2011
Last Update Date : 11/09/2011

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Directions to “HOYLETON YOUTH AND FAMILY SERVICES ” Practice Location

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