West Lake Residential - Building 220
NPI #1104071125 in Springfield, Illinois
Provider Information
- NPI Number
- 1104071125
- Entity Type
- Organization
- Organization Name
- West Lake Residential - Building 220
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MENTAL HEALTH CENTERS OF CENTRAL ILLINOIS
- Primary Specialty
- Community Based Residential Treatment Facility, Mental Illness
- Enumeration Date
- Nov 18, 2008
- Last Updated
- Oct 31, 2023
Practice Location
- Address
- 200 W LAKE DR
- Address 2
- BUILDING 220
- City
- Springfield
- State
- Illinois
- ZIP Code
- 62703-4956
- Phone
- (217) 588-7934
Authorized Official
- Name
- ANN BOWLING
- Title
- DIRECTOR
- Phone
- (217) 588-2626
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Mental Illness |
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