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Mr. Demingo Collins
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in O Fallon, Illinois
NPI 1518724673

Demingo Collins is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in O Fallon, IL. Demingo Collins practices in O Fallon, IL. The NPI Number for Demingo Collins is 1518724673 and holds a License No. 202400006C (Illinois).

The current practice location address for Demingo Collins is 613 Laurelwood Ct, O Fallon, IL and can be reached out via phone at 702-875-1766.

Location: 613 Laurelwood Ct, O Fallon, IL, 62269-7064
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518724673
Provider Name
Demingo Collins
Credential
Provider Entity Type
Individual
Gender
Male
Address
613 Laurelwood Ct, O Fallon, IL, 62269-7064
Phone Number
702-875-1766
Fax Number
Provider Enumeration Date
03/04/2024
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
613 Laurelwood Ct
City
O Fallon
State
Illinois
Zip
62269-7064
Phone Number
702-875-1766
Fax Number
person
Provider Business Mailing Address Details
Address
613 Laurelwood Ct
City
O Fallon
State
Illinois
Zip
62269-7064
Phone Number
702-875-1766
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
202400006C (Illinois)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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