NPI 1043867112

Southern Illinois Center for Independent Living

Organisation Case Management Agency Carbondale, IL

Practice location

Address: 2135 W. Ramada Lane, Carbondale, IL 62901-5326
Phone: (618) 457-3318
Fax: (618) 549-0132

Authorised official

Name: Bonnie Vaughn
Title: Executive Director
Phone: (618) 457-3318

Registered specialties (3)

Case Management Agency Primary

Agencies Taxonomy 251B00000X

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Voluntary or Charitable Agency

Agencies Taxonomy 251V00000X

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In Home Supportive Care Agency

Agencies Taxonomy 253Z00000X

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Registry record

NPI: 1043867112
Entity type: Organization
NPI issued: 22 Aug 2019
Record last updated: 22 Aug 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.