Organization
LIBERTY COUNSELING CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA K EYMAN MS,CADC,MISAII (PRESIDENT/DIRECTOR)
(217) 479-0691
Entity
Organization
Contact information
Practice address
1429 S MAIN ST, SUITE A, JACKSONVILLE, IL 62650-3476
(217) 479-0691
(217) 478-2060
Mailing address
1429 S MAIN ST, SUITE A, JACKSONVILLE, IL 62650-3476
(217) 479-0691
(217) 478-2060
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A-7302-0001-A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
C/A-7302-0001-A
—
IL
Enumeration date
02/15/2011
Last updated
02/15/2011
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