Provider Demographics
NPI:1215992060
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:VICE PRESIDENT/COO
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:LPHA
Authorized Official - Phone:618-493-7382
Mailing Address - Street 1:350 N MAIN ST
Mailing Address - Street 2:P.O. BOX 218
Mailing Address - City:HOYLETON
Mailing Address - State:IL
Mailing Address - Zip Code:62803-2006
Mailing Address - Country:US
Mailing Address - Phone:618-493-7382
Mailing Address - Fax:618-493-7504
Practice Address - Street 1:350 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HOYLETON
Practice Address - State:IL
Practice Address - Zip Code:62803-2006
Practice Address - Country:US
Practice Address - Phone:618-493-7382
Practice Address - Fax:618-493-7504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL033699320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities