Organization
SPARROW PEDIATRICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBIN LEEANN MOORE MS, OTRL (PRESIDENT)
(217) 299-0952
Entity
Organization
Contact information
Practice address
2437 E KEYS AVE, SPRINGFIELD, IL 62702-3207
(217) 299-0952
(217) 679-2497
Mailing address
2437 E KEYS AVE, SPRINGFIELD, IL 62702-3207
(217) 299-0952
(217) 679-2497
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
056005705
IL
Other
Enumeration date
11/28/2006
Last updated
09/26/2012
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