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Organization
PARK PLACE CENTER
Active
Organization
PARK PLACE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ED J SCOTT L.C.S.W. (DIRECTOR)
(217) 245-1655
Entity
Organization
Contact information
Practice address
201 E MORGAN ST, JACKSONVILLE, IL 62650-2508
(217) 245-1655
(217) 245-4742
Mailing address
201 E MORGAN ST, P.O. BOX 1304, JACKSONVILLE, IL 62650-2508
(217) 245-1655
(217) 245-4742
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.003173
IL
Other
Enumeration date
05/25/2007
Last updated
10/05/2012
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