Mr. Demingo Collins
Mr. Demingo Collins is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in O Fallon, Illinois. Practices as a sole proprietor. Licensed in Illinois.
- Licensed in
- IL
- In the registry since
- 2024
Practice location Address checks out
613 Laurelwood CtO Fallon, IL 62269-7064
Phone: (702) 875-1766
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Specialties & licences
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) | Taxonomy 320900000X · Licence 202400006C (IL) |
|---|
Record details
| NPI number | 1518724673 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | March 4, 2024 |
| Last updated in NPPES | March 4, 2024 |
| Certification date | March 4, 2024 |
| Mailing address | 613 Laurelwood Ct, O Fallon, IL 62269-7064 |
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