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Organization
PERRY COUNTY COUNSELING CENTER INC
Active
Organization
PERRY COUNTY COUNSELING CENTER INC
Active
Other names
Southern Illinois Behavioral Services
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R VENSKUS (EXECUTIVE DIRECTOR)
(618) 542-4357
Entity
Organization
Contact information
Practice address
104 S HICKORY ST, DU QUOIN, IL 62832-1839
(618) 542-6722
(618) 542-6623
Mailing address
8271 E JACKSON STREET RD, DU QUOIN, IL 62832-3811
(618) 542-6722
(618) 542-6623
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180004129
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012300790
—
IL
Enumeration date
04/06/2009
Last updated
04/06/2009
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