NPI 1639651706

Shawnee Health Service and Development Corp

Organisation Case Management Agency Carterville, IL

Practice location

Address: 109 California St, Carterville, IL 62918-1923
Phone: (618) 519-9200
Mailing address: 109 California St PO Box 577, Carterville, IL 62918-0577

Authorised official

Name: Patsy R Jensen
Title: Ceo
Phone: (618) 985-8221

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X

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Registry record

NPI: 1639651706
Entity type: Organization
NPI issued: 5 Sep 2018
Record last updated: 27 Sep 2018

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.