Organization
COUNTY OF CLARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHY HAYDEN (ADMINISTRATOR)
(217) 382-4207
Entity
Organization
Contact information
Practice address
997 N YORK STREET, MARTINSVILLE, IL 62442-0266
(217) 382-4207
Mailing address
PO BOX 266, 997 N YORK STREET, MARTINSVILLE, IL 62442-0266
(217) 382-4207
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
10/31/2006
Last updated
08/22/2020
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