Organization
COUNTY OF CLAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHELSEA MUSGRAVE (CHIEF HUMAN RESOURCES OFFICER)
(618) 662-2131
Entity
Organization
Contact information
Practice address
413 PARK STREET, CISNE, IL 62823
(618) 844-3300
Mailing address
PO BOX 280, FLORA, IL 62839-0280
(618) 662-2131
(618) 662-1482
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/08/2015
Last updated
05/10/2018
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