NPI | 1235780982 |
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Doing Business As | SHAWNEE HEALTH CARE, CARTERVILLE SUD |
Entity Type | Organization |
Authorized Contact | PATSY R JENSEN CEO 618-956-9508 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
Enumeration Date | 2019-09-24 |
Last Update Date | 2019-09-24 |