Organization
COMMUNITY ELEMENTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER CHANEY (EMPLOYMENT SPECIALIST)
(217) 693-4613
Entity
Organization
Contact information
Practice address
202 W PARK AVE, CHAMPAIGN, IL 61820-3929
(217) 373-2430
Mailing address
202 WEST PARK STREET, CHAMPAIGN, IL 61820
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
101YM0800X
IL
Other
Enumeration date
11/03/2010
Last updated
11/03/2010
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