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Organization

SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, INC.

Active
Other names
Charleston Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
LARRY MCCULLEY (CEO)
(618) 332-0694
Entity
Organization

Contact information

Practice address
626 W LINCOLN AVE, CHARLESTON, IL 61920-2444
(217) 345-7702
(217) 345-7705
Mailing address
2041 GOOSE LAKE RD, SAUGET, IL 62206-2822
(618) 332-0953
(618) 332-2487

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
122300000X
Dentist
207Q00000X
Family Medicine Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Enumeration date
03/10/2014
Last updated
06/02/2016
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