Willowglen Academy

NPI #1962171173 in Springfield, Illinois

Provider Information

NPI Number: 1962171173
Entity Type: Organization
Organization Name: Willowglen Academy
Primary Specialty: Community Based Residential Treatment Facility, Mental Illness
Enumeration Date: Sep 10, 2021
Last Updated: Sep 10, 2021

Practice Location

Address: 1520 HOSTA ST
City: Springfield
State: Illinois
ZIP Code: 62712-7557
Phone: (414) 240-6815

Authorized Official

Name: KEDRIAN COLEMAN
Title: DIRECTOR REVENUE CYCLE
Phone: (919) 709-0197

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X	Primary

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