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1902447196
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
CARBONDALE, IL
NPI
1902447196
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Entity Type
Organization
Authorized Contact
PATSY R JENSEN
CEO
618-956-9508
Organization Subpart ?
Yes
Primary Taxonomy
261QM2800X Clinic/Center Methadone
Enumeration Date
2019-09-30
Last Update Date
2019-09-30
Business Address
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
101 S WALL ST
CARBONDALE, IL 62901-3021
Phone number: 618-519-9200
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Mailing Address
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
PO BOX 577 109 CALIFORNIA ST
CARTERVILLE, IL 62918-0577
Phone number: 618-519-9200
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