Organization
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Active
Parent organization
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Other names
Jefferson Elementary School Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Authorized official
CHRISTINA CARNEY (CEO)
(618) 956-9521
Entity
Organization
Contact information
Practice address
700 E BOULEVARD ST, MARION, IL 62959-3306
(618) 519-9200
(618) 998-0880
Mailing address
109 CALIFORNIA ST, PO BOX 577, CARTERVILLE, IL 62918
(618) 519-9200
(618) 985-6860
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
1223G0001X
General Practice Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
01/06/2023
Last updated
07/29/2024
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