Good Samaritan House of Granite City, INC
NPI #1134612054 in Granite City, Illinois
Provider Information
- NPI Number
- 1134612054
- Entity Type
- Organization
- Organization Name
- Good Samaritan House of Granite City, INC
- Primary Specialty
- Clinic/Center - Adolescent and Children Mental Health
- Enumeration Date
- Jun 14, 2018
- Last Updated
- Jun 14, 2018
Practice Location
- Address
- 1825 DELMAR AVE
- City
- Granite City
- State
- Illinois
- ZIP Code
- 62040-4508
- Phone
- (618) 876-0607
Authorized Official
- Name
- MS. LATOSHA R DAVIS, LCSW
- Title
- EXECUTIVE DIRECTOR
- Phone
- (618) 219-9513
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center) |
| Clinic/Center - Adult Mental Health — Adult Mental Health |
| Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health |
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