Organization
ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS
Active
Other names
SSM Health St. Mary's Hospital - Centralia
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAMON R HARBISON (PRESIDENT)
(618) 436-8000
Entity
Organization
Contact information
Practice address
400 N PLEASANT AVE, CENTRALIA, IL 62801
(618) 436-8000
Mailing address
1195 CORPORATE LAKE DR, SAINT LOUIS, MO 63132-1716
(314) 989-3524
(314) 989-3695
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
0002642
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
154401
HEALTH ALLIANCE
IL
Enumeration date
03/27/2006
Last updated
11/27/2023
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