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GOOD SAMARITAN HOUSE OF GRANITE CITY, INC
NPI 1134612054
Clinic/Center - Adolescent and Children Mental Health in Granite City, IL

Active since June 14, 2018
1825 DELMAR AVE, GRANITE CITY, IL 62040(618) 876-0607 Get Directions Write a Review

NPPES record last updated: June 14, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Good Samaritan House Of Granite City, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GOOD SAMARITAN HOUSE OF GRANITE CITY, INC (NPI 1134612054) is a healthcare organization registered as an adolescent and children mental health in Granite City, Illinois and active in the NPI registry since June 2018. The organization lists Latosha R Davis, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1134612054
Entity TypeOrganization
Primary Taxonomy261QM0855X
Legal Business NameGOOD SAMARITAN HOUSE OF GRANITE CITY, INC
Location Address1825 DELMAR AVEGranite City, IL 62040-4508
Mailing Address1825 Delmar AveGranite City, IL 62040-4508 · (618) 876-0607
Phone(618) 876-0607
Organization SubpartNo
Authorized OfficialLatosha R DavisExecutive Director · (618) 219-9513
Enumeration DateJune 14, 2018
✔ NPI 1134612054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0855X
License✔ Licensed in IL · 149.019998
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.
Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X · License 149.019998 (IL)
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X · License 149.019998 (IL)
1825 DELMAR AVE, Granite City, IL 62040
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ALETHA ANN HOGAN L.P.N.
Licensed Practical Nurse
1825 DELMAR AVE
GRANITE CITY, IL 62040
Madison County (618) 876-0607

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Good Samaritan House Of Granite City, Inc's NPI number?

The NPI number for Good Samaritan House Of Granite City, Inc is 1134612054. It was assigned to this organization in the NPPES registry on June 14, 2018.

Where is Good Samaritan House Of Granite City, Inc located?

Good Samaritan House Of Granite City, Inc is located at 1825 Delmar Ave, Granite City, IL 62040. The listed phone number is (618) 876-0607.

What is Good Samaritan House Of Granite City, Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

When was this NPI record last updated?

The NPPES record for Good Samaritan House Of Granite City, Inc was last updated on June 14, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.