Provider Demographics
NPI:1457775108
Name:HOYLETON YOUTH AND FAMILY SERVICES
Entity Type:Organization
Organization Name:HOYLETON YOUTH AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:618-493-7382
Mailing Address - Street 1:350 NORTH MAIN
Mailing Address - Street 2:P.O. BOX 218
Mailing Address - City:HOYLETON
Mailing Address - State:IL
Mailing Address - Zip Code:62803-0218
Mailing Address - Country:US
Mailing Address - Phone:618-493-7382
Mailing Address - Fax:618-493-6390
Practice Address - Street 1:300 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-4024
Practice Address - Country:US
Practice Address - Phone:618-416-7337
Practice Address - Fax:618-416-7097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
IL010020251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management