Hazel Bland Promise Center
NPI #1235580564 in East Saint Louis, Illinois
Provider Information
- NPI Number
- 1235580564
- Entity Type
- Organization
- Organization Name
- Hazel Bland Promise Center
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Jun 28, 2016
- Last Updated
- Jun 28, 2016
Practice Location
- Address
- 2900 STATE ST
- City
- East Saint Louis
- State
- Illinois
- ZIP Code
- 62205-2234
- Phone
- (618) 274-3500
Authorized Official
- Name
- MS. VIVIAN E. THOMPSON
- Title
- FAMILY SUPPORT UNIT DIRECTOR
- Phone
- (618) 274-3500
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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