Illinois Mentor
NPI #1326376591 in O Fallon, Illinois
Provider Information
- NPI Number
- 1326376591
- Entity Type
- Organization
- Organization Name
- Illinois Mentor
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- ILLINOIS MENTOR
- Primary Specialty
- Foster Care Agency
- Enumeration Date
- Nov 30, 2009
- Last Updated
- Nov 30, 2009
Practice Location
Authorized Official
- Name
- VIVIANE NGWA, MSW
- Title
- EXECUTIVE DIRECTOR
- Phone
- (708) 679-9137
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Management |
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Foster Care Agency |
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