| NPI | 1205564119 |
|---|---|
| Doing Business As | CARBONDALE CARE A VAN |
| Entity Type | Organization |
| Authorized Contact | IRIS WESLEY CEO 217-757-8137 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2022-08-09 |
| Last Update Date | 2022-08-09 |