Chaddock Attachment and Trauma Services
Organization Active NPI Foster Care Agency · Carthage, IL
NPI 1093594483 · NPPES record last updated Sep 25, 2023
Key facts
- NPI
- 1093594483
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Foster Care Agency 253J00000X
- Legal business name
- CHADDOCK ATTACHMENT AND TRAUMA SERVICES
- Practice address
- 100 W Buchanan St
Carthage, IL 62321-1249 - Phone
- (217) 222-0034
- NPI assigned
- Sep 25, 2023
- Organization subpart
- Yes
- Parent organization (as reported)
- CHADDOCK ATTACHMENT AND TRAUMA SERVICES
Authorized official
- Name
- Kristen Patton
- Title
- Director of Finance
- Phone
- (217) 592-0317
Corporate family (same tax ID) 6
National Provider Directory
- Tax ID family
- Chaddock
- Part of
- Chaddock
Locations
100 W Buchanan St
Carthage, IL 62321
Phone (217) 222-0034
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foster Care Agency | 253J00000X | Yes | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X |
Addresses
Primary practice location
100 W Buchanan St
Carthage, IL 62321-1249
Mailing address
205 S 24TH St
Quincy, IL 62301-4446
Phone (217) 222-0034
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3A00-IPI-019 | Medicaid | IL |
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All providers in Carthage, IL · Foster Care Agency in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.