Marys Village Foundation
NPI #1104560838 in Belleville, Illinois
Provider Information
- NPI Number
- 1104560838
- Entity Type
- Organization
- Organization Name
- Marys Village Foundation
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Apr 27, 2022
- Last Updated
- Apr 27, 2022
Practice Location
- Address
- 3922 N BELT W
- City
- Belleville
- State
- Illinois
- ZIP Code
- 62226-5608
- Phone
- (618) 974-4807
Authorized Official
- Name
- MISS SHANTA DOSS, MS
- Title
- OWNER
- Phone
- (618) 974-4807
Specialties & Taxonomy Codes
| Specialty |
|---|
| Driver |
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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