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Organization

SOUTHWESTERN ILLINOIS COLLEGE PROGRAMS FOR OLDER PSREONS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VICKI ROSE (EXECUTIVE DIRECTOR)
(618) 234-4410
Entity
Organization

Contact information

Practice address
201 N CHURCH ST, BELLEVILLE, IL 62220-4005
(618) 234-4410
(618) 234-8634
Mailing address
201 N CHURCH ST, BELLEVILLE, IL 62220-4005
(618) 234-4410
(618) 234-8634

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
IL

Other

Enumeration date
05/31/2005
Last updated
07/21/2022
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