Organization
SOUTH SIDE OFFICE OF CONCERN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTINE E KAHL CADC (EXECUTIVE DIRECTOR)
(309) 674-7310
Entity
Organization
Contact information
Practice address
1316 SW ADAMS ST, PEORIA, IL 61602-1702
(309) 674-7310
(309) 674-9652
Mailing address
301 NE JEFFERSON STREET, PEORIA, IL 61602-1212
(309) 674-7310
(309) 674-9652
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
04125
IL
Other
Enumeration date
05/29/2007
Last updated
04/23/2008
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