Organization
SOUTHERN ILLINOIS REGIONAL WELLNESS CENTER
Active
Organization
SOUTHERN ILLINOIS REGIONAL WELLNESS CENTER
Active
Other names
Health and Opportunity Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK R FREELAND (EXECUTIVE DIRECTOR)
(618) 874-3120
Entity
Organization
Contact information
Practice address
1835 KINGSHIGHWAY, WASHINGTON PARK, IL 62204-2135
(618) 482-7922
(618) 482-7881
Mailing address
1835 KINGSHIGHWAY, WASHINGTON PARK, IL 62204-2135
(618) 482-7922
(618) 482-7881
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
01/26/2007
Last updated
12/06/2011
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