# HENDERSON COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821001595
- **Authorized official:** DIANA SEITZ (OFFICE MANAGER)
- **Authorized official phone:** (309) 627-2812

## Contact information

- **Practice address:** 208 WEST ELM STREET, GLADSTONE, IL 61437-0220
- **Practice address phone:** (309) 627-2812
- **Practice address fax:** (309) 627-2305
- **Mailing address:** 208 WEST ELM STREET, P O BOX 220, GLADSTONE, IL 61437-0220
- **Mailing address phone:** (309) 627-2812
- **Mailing address fax:** (309) 627-2305

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 1001502 | IL | Yes |
| 251G00000X | Community Based Hospice Care Agency | — | NULL | — |
| 261QP0905X | State or Local Public Health Clinic/Center | 1001502 | IL | — |

## Other

- **Enumeration date:** 08/14/2006
- **Last updated:** 02/20/2024