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Soul Apothecary, Llc
Adolescent and Children Mental Health Clinic/Center in O Fallon, Illinois
NPI 1417699471

Soul Apothecary, Llc is an Adolescent and Children Mental Health Clinic/Center based in O Fallon, IL and is specialized in Adolescent and Children Mental Health. Soul Apothecary, Llc practices in O Fallon, IL. The NPI Number for Soul Apothecary, Llc is 1417699471 and holds a License No. (Illinois).

The current practice location address for Soul Apothecary, Llc is 787 Sunset Blvd, O Fallon, IL and can be reached out via phone at 618-292-8964.

Location: 787 Sunset Blvd, O Fallon, IL, 62269-1301
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1417699471
Provider Name
Soul Apothecary, Llc
Credential
Provider Entity Type
Organization
Address
787 Sunset Blvd, O Fallon, IL, 62269-1301
Phone Number
618-292-8964
Fax Number
Provider Enumeration Date
04/11/2022
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
787 Sunset Blvd
City
O Fallon
State
Illinois
Zip
62269-1960
Phone Number
618-292-8964
Fax Number
person
Provider Business Mailing Address Details
Address
787 Sunset Blvd
City
O Fallon
State
Illinois
Zip
62269-1960
Phone Number
618-292-8964
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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