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Organization
SPRING GARDEN COMMUNITY CONSOLIDATED SCHOOL DISTRICT #178
Active
Organization
SPRING GARDEN COMMUNITY CONSOLIDATED SCHOOL DISTRICT #178
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NIKKI DAWN STRAIN (ADMINISTRATIVE ASSISTANT)
(618) 244-8070
Entity
Organization
Contact information
Practice address
14975 E BAKERVILLE RD, MOUNT VERNON, IL 62864
(618) 244-8070
(618) 244-8071
Mailing address
14975 E BAKERVILLE RD, MOUNT VERNON, IL 62864
(618) 244-8070
(618) 244-8071
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/06/2007
Last updated
07/31/2015
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