Organization
KASKASKIA WORKSHOP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG SHAVER (CEO)
(618) 533-4423
Entity
Organization
Contact information
Practice address
299 SWAN AVE, CENTRALIA, IL 62801
(618) 533-4423
Mailing address
PO BOX 1946, CENTRALIA, IL 62801-9127
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
IL
Other
Enumeration date
01/30/2007
Last updated
12/03/2015
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